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Hemostasis modulators: The next generation of anticancer molecules?

Between 1970 and 1994, cancer claimed the lives of about 0.5 million Americans every year. According to the most recent statistics, it is estimated that well over 1 million new cases of cancer will be diagnosed and 555,500 people will die from cancer in the United States in the year 2002. From 1992 to 1998, the incidence of cancer related death was reduced by 1.1%. This modest improvement was related to improved detection and greater therapeutic options which can be sub-divided into a number of different therapeutic classes including classic alkylating agents and anti-metabolites and new concepts such as angiogenesis inhibitors and apoptosis activators. An emerging target for cancer therapy that has received considerable attention in recent additions of TherapeuticAdvances is the coagulation system. Disseminated intravascular coagulopathy is very common in cancer patients and indeed, thromboembolism is one of the most common causes of death in this cohort. As well as contributing to the end stages of tumor progression, components of the hemostatic pathways support metastasis, angiogenesis and proliferation. Such effects can result from a direct effect of coagulants on cells involved in tumor progression or an indirect effect mediated by platelets. Manipulation of hemostatic pathways may minimize tumor progression and associated thromboembolic complications. However, since surgery is the primary treatment for most cancers, the angiogenesis of wound healing and hemostatic competence must be maintained. Selective blockade of hemostatic pathways within the tumor environment represents a highly novel class of cancer therapy

Link to journal abstract:

The role of the coagulation system in tumour angiogenesis.

Adapted from Nash et al, Lancet Oncol 2001 Oct;2(10):608-13 

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