Coagulome and the tumor microenvironment: an actionable interplay

Abstract

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Molecular Landscape of the Coagulome of Oral Squamous Cell Carcinoma

“…These data suggest that coagulation and thrombin, rather than directly modulating the behavior of OSCC cells, might exert some of their effects on the TME of these tumors. Importantly, the notion that the coagulation process might influence the different cell populations that constitute the TME is mounting [ 41 ]. The possibility that the tumor coagulome and the TME mutually regulate each other deserves further study when considering the increasingly recognized role of the TME as a therapeutic target [ 20 , 21 ].…”

Targeting coagulation to unlock antitumor immunity?

“…1 As a consequence of this hypercoagulant state, solid tumors often induce systemic complications, such as venous thromboembolism, that account for significant mortality and morbidity (especially in glioblastoma, lung carcinoma or pancreatic adenocarcinoma). 1 The role of the coagulation cascade as a source of hemostatic complications has motivated the development of pharmacological anticoagulant agents, such as low-molecular weight heparins or direct oral anticoagulants (DOAC). Despite an attractive preclinical rationale, preventing thomboembolic accidents in cancer patients has proven difficult and current anticoagulation protocols have failed to broadly extend the survival of ambulatory cancer patients.…”

“…Despite an attractive preclinical rationale, preventing thomboembolic accidents in cancer patients has proven difficult and current anticoagulation protocols have failed to broadly extend the survival of ambulatory cancer patients. 1 Lack of personalization and the intrinsic narrow therapeutic window of the available treatments (that target the common effectors of coagulation, thus inducing hemorrhage and bleeding), could explain this. 1 …”

“… 1 Lack of personalization and the intrinsic narrow therapeutic window of the available treatments (that target the common effectors of coagulation, thus inducing hemorrhage and bleeding), could explain this. 1 …”

“…We argue that re-exploring coagulation in this framework is important, given the existence of an actionable interplay between the coagulome and the TME. 1 Importantly, potent anticoagulants are readily available. While their ability to extend the survival of cancer patients as single agents is questionable, they might be useful as an adjunct to ICB to boost anti-tumor immunity.…”