Tissue factor-related biomarkers during combined androgen blockade in patients with prostate cancer: A brief report

Men undergoing combined androgen blockade therapy (CAB) for prostate cancer are at risk of thromboembolism. Tissue factor (TF) and microparticle-associated tissue factor activity (MP-TF) play a role in coagulation and may detect early coagulation changes during hormonal therapy. However, therapy-related hemostatic alterations remain poorly understood. We prospectively studied men with localized and locally advanced prostate cancer treated with CAB through two pathways: radiotherapy (RT) plus CAB (RT + CAB) for localized disease, and radical prostatectomy (RP) followed by adjuvant radiotherapy (ART) and CAB (RP + ART+CAB) for locally advanced disease. We assessed whether TF-related biomarkers were modified during diagnosis and whether this profile remained after 6 months of CAB. We evaluated longitudinal biomarker changes, pathway differences, and their relationship with routine coagulation tests. Circulating TF levels were elevated at baseline and increased after CAB. MP-TF activity remained elevated, with no significant longitudinal change. No significant differences were observed between the treatment pathways (p > 0.05). Routine coagulation parameters remained stable and did not reflect biomarker changes. CAB therapy was associated with increased circulating TF levels and a persistent procoagulant microparticle profile, not reflected by routine coagulation assays. Larger studies with clinical thrombotic endpoints are needed to confirm their clinical relevance.