Novel Insights into Mechanisms of Cancer-Associated Thrombosis: 2nd Edition

Dear Colleagues,

Cancer-associated thrombosis (CAT) represents a major cause of mortality in cancer patients and presents a significant clinical challenge. The pathophysiology of CAT involves a multifaceted interplay of cancer-related factors, including the enhanced expression and release of procoagulant proteins such as the Von Willebrand Factor and tissue factor and alterations in blood flow due to tumour burden. The pathophysiology may then be further exacerbated by surgery, chemotherapy and novel therapies such as proteasome inhibitors and CAR-T cell therapy. While venous thrombosis is the most common type of CAT, patients can also experience arterial thrombosis and, in extreme cases, disseminated intravascular coagulation and thrombotic microangiopathy.  Anticoagulation therapy is the cornerstone of management, with low-molecular-weight heparin (LMWH) being the preferred agent due to its efficacy and lower bleeding risk compared to traditional vitamin K antagonists. Clinical guidelines recommend prophylactic anticoagulation in high-risk patients, especially during periods of hospitalisation or following major surgeries. Ongoing research is required to elucidate the precise mechanisms of CAT further and refine treatment protocols, emphasising personalised approaches to optimise patient outcomes and mitigate the complications associated with CAT in the cancer population. This Special Issue will highlight our current understanding of the mechanisms behind CAT from the molecular level through to patient cohorts.

Dr. Tom A J Mckinnon
Guest Editor

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