The search for a deeper understanding of the molecular interactions that occur between thrombosis and cancer is furthering our understanding of the key oncogenes that drive prothrombotic pathways, particularly in malignant brain tumours. Janusz Rak’s finding in his latest elegant work will be soon presented in a session of the upcoming 9th ICTHIC Conference (Bergamo, Italy, 13-15 April 2018), devoted to the mechanisms that relate cancer and thrombosis.
During the course of the last 15 years, the ICTHIC conferences have witnessed important discoveries in such “dangerous liaisons.” ICTHIC was one of the first meetings in which the early findings on the role of tissue factor in promoting tumour progression were reported. At this year’s meeting, Claudine Graf and Wolfram Ruf will review the evidence for the important role of tissue factor (TF)-mediated cell signalling and clotting in cancer and inflammation. The evidence supports the thesis that TF signalling will continue to be an attractive target for cancer therapy.
In the meantime, new approaches have been emerging in a variety of pre-clinical models for different targets, such as neutrophil extracellular traps (NETs) interacting with platelets. Anna-Karin Olsson, from Uppsala, Sweden, and her colleagues call it a compelling and “sticky” mechanism for tumour growth and a potentially intriguing target for anti-cancer therapy.
The next step forward will focus on the control and reduction of tumour growth and angiogenesis using anticoagulants and related molecules. Yona Nadir and Benjamin Brenner of Haifa, Israel, have assessed several novel strategies and will show novel data in Bergamo from some phase I/II clinical trials.
However, in such a promising translational scenario, what drives physicians’ decisions in real life clinical settings? Treating VTE and preventing recurrent VTE has become a debated and challenging issue, especially when it relates to cancer. The current guidelines as well as results from the most recent clinical trials and data from registries, such as GARFIELD VTE, need to be discussed in the light of a new comprehensive approach to VTE treatment in cancer patients. Agnes Lee, Giancarlo Agnelli, Ajay Kakkar and Sam Shulman will offer their expert opinion and guidance in an effort to devise a discerning approach to the therapeutical management of these patients.
The field is both challenging and rapidly growing, and multiple views and experiences must be shared in order to better our understanding of it. A constant overarching theme of the ICTHIC Conference has been the close relationship between basic science and clinical medicine in the approach to haemostasis and thrombosis in cancer. This overlap, at the basic level, between blood coagulation and tumour biology, in addition to the appropriate use of anticoagulants in patients with cancer, has remained a crucial issue at the ICTHIC Conferences over the years. And the search for a better understanding of these mechanisms continues in Bergamo.