"Targeting platelets in breast cancer: Insights into pathophysiology and therapeutic strategies"

Breast cancer cells establish complex interactions with platelets, leading to platelet activation and their transformation into cells that support tumor growth and progression. Activated platelets promote cancer cell proliferation, angiogenesis, and metastasis through the secretion of bioactive factors, including TGF-β, VEGF, and PDGF. Through multiple signaling pathways, activated platelets accelerate epithelial-mesenchymal transition (EMT) and tumor cell intravasation. They also protect circulating tumor cells and, by inhibiting natural killer (NK) cells, facilitate immune evasion and infiltration into metastatic target tissues. Furthermore, platelets release various factors that prepare the metastatic niche and support clonal expansion at distant sites. Given their facilitating roles at multiple stages of breast cancer progression, platelets represent promising targets for targeted therapies and drug delivery to cancer cells. In this Review, we present a detailed picture of the roles of platelets at different stages of breast cancer progression and illustrate emerging strategies for targeting them in cancer therapy.