Evolving biomarkers and risk prediction models in colorectal cancer-associated venous thromboembolism
Lan Sun a b 1, Jia Wang c 1, Yi-Dan Yan c, Long-Tu Li a b, Lin-Yu Cao a, Ruo-Fei Li a b, Shan Chong a b, Meng Hu c, Hou-Wen Lin c d, Yi-Min Cui a, Zhi-Chun Gu c d, Qian Xiang a
a) Institute of Clinical Pharmacology, Peking University, Beijing, 100191, China
b) Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences Peking University Health Science Center, Beijing, 100191, China
c) Department of Pharmacy, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
d) College of Clinical Pharmacy, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China
Abstract
The pathological hypercoagulable state and associated risk of thrombosis in colorectal cancer (CRC) persist throughout the disease course. Accurate identification of patients at high risk of venous thromboembolism (VTE) and judiciously applying drug or mechanical prevention measures can significantly reduce the incidence of VTE. The review details a range of biomarkers, including platelet count, soluble P-selectin, D-dimer, and vascular endothelial growth factor (VEGF), which have been shown to correlate with increased VTE risk in CRC patients. In addition to the biomarker analysis, the review makes important recommendations for the routine monitoring of these biomarkers in CRC patients, especially those at higher risk for VTE. Furthermore, it discusses the integration of these biomarkers into clinical VTE risk prediction models, advocating for personalized and targeted thromboprophylaxis strategies. The review also explores future research directions, emphasizing the potential of antiplatelet and anticoagulant therapies in improving the prognosis of CRC patients by reducing thromboembolic events. This narrative review not only deepens our understanding of the molecular mechanisms driving cancer-associated thrombosis but also paves the way for novel therapeutic interventions aimed at preventing VTE in CRC patients.