The role of coagulome in the tumor immune microenvironment

Wahab, Riajul; Hasan, Md. Mahedi; Azam, Zulfikar; Grippo, Paul J.; Al-Hilal, Taslim A.

doi:10.1016/j.addr.2023.115027

Cited by 5 publications

(4 citation statements)

References 196 publications

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“…However, it is resisted by clinicians due to the fear of bleeding. [ 14 22 23 24 ] TEG-guided transfusion algorithms also decreased the blood component transfusion requirements. [ 25 ] TEG can impact the rate of blood component transfusion and its associated complications.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of perioperative routine coagulation testing versus thromboelastography for major liver resection – A single-arm, prospective, interventional trial (PORTAL trial)

Ambulkar,

Baskar,

Patkar

et al. 2023

Indian Journal of Anaesthesia

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Background and Aims: The International Normalised Ratio (INR), which assesses the loss of procoagulant factors in the extrinsic pathway, fails to evaluate the coagulation abnormalities comprehensively after a major liver resection, which often leads to reduced synthesis of procoagulant and anticoagulant-factors. This study was conducted with an aim to study the trend and compare the results of routine coagulation tests and thromboelastography (TEG) during the perioperative period in patients undergoing major liver resections (≥3 segments). Methods: Twenty-five patients who underwent a major liver resection were enrolled. This prospective, single-arm, interventional study was performed with the primary objective of determining the serial changes in conventional coagulation tests and TEG during the perioperative period in patients undergoing major liver resections, at the preincision period, intraoperative period, postoperatively, at 48 h and on the fifth postoperative day. Transfusion requirements of blood components were also assessed with a TEG-guided replacement strategy. Spearman rank-order correlation was used to study the relationships of coagulation tests (both TEG and conventional tests) at each time point. Results: The prothrombin time (PT)-INR was elevated in 14 patients (56%) at the intraoperative, immediate postoperative and 48-h time points in contrast to the TEG parameters, which remained normal in all patients. Blood component transfusion was avoided in 4, 11 and 10 patients at the intraoperative, immediate postoperative and 48-h time points, respectively. Conclusion: International Normalised Ratio overestimates the coagulopathy in patients undergoing major liver resection, and a thromboelastography-guided transfusion strategy reduces overall transfusion requirements.

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Section: Discussionmentioning

confidence: 99%

Evaluation of perioperative routine coagulation testing versus thromboelastography for major liver resection – A single-arm, prospective, interventional trial (PORTAL trial)

Ambulkar,

Baskar,

Patkar

et al. 2023

Indian Journal of Anaesthesia

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“…Since hyperthermia can enhance the efficacy of chemotherapy and targeted therapies, there’s potential to explore how it interacts with CTLA-4 inhibitors ( 38 , 39 ). Hyperthermia may alter the tumor microenvironment in a way that makes immunotherapy more effective ( 40 ). Indeed, CTLA-4, capecitabine, chemotherapy in colorectal cancer and immune checkpoint, immune checkpoint inhibitors and immunotherapy are crucial topics and should be given more attention in the future.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of mFOLFOX6 plus bevacizumab regimen in advanced colorectal cancer after deep hyperthermia: a single-center retrospective study

Han,

Cui,

Sun

et al. 2023

Front. Oncol.

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BackgroundThis study aimed to explore the clinical efficacy and safety of a modified FOLFOX6 (oxaliplatin + leucovorin + 5-fluorouracil) plus bevacizumab regimen after deep hyperthermia in advanced colorectal cancer.MethodsA total of 80 colorectal cancer patients treated at our hospital were selected as research subjects. According to the random number table method, patients were divided into a control group (mFOLFOX6 plus bevacizumab) and a combination group (mFOLFOX6 plus bevacizumab after deep hyperthermia treatment), with 40 patients in each group. After six cycles of treatment, the objective response rate (ORR), disease control rate (DCR), levels of serum tumor markers carcinoembryonic antigen (CEA), vascular epidermal growth factor (VEGF), Karnofsky performance status (KPS) scores, and the occurrence of adverse events were compared between the two groups.ResultsAfter six cycles of treatment, the ORR in the combination group was higher than that in the control group, but the difference was not statistically significant (P>0.05). The DCR in the combination group was significantly higher than that in the control group (P<0.05). The serum CEA levels in the control and combination groups after treatment were significantly lower than those before treatment, and the serum CEA and VEGF levels in the combination group were significantly lower than those in the control group (all P<0.001). The KPS scores in both groups after treatment were higher than those before treatment, and the KPS scores in the combination group after treatment were significantly higher than those in the control group (all P<0.001). The incidence of fatigue and pain in the combination group was significantly lower than that in the control group (P<0.05).ConclusionmFOLFOX6 plus bevacizumab after deep hyperthermia is effective in advanced colorectal cancer patients, which can effectively improve their quality of life, and the adverse events are controllable and tolerable. A randomized or prospective trial will be required to further prove these data and explore its potentiality, especially if compared to conventional treatment.

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“…This process has been suggested to promote immune evasion and to inhibit the response to immune checkpoint blockade in cancer patients by altering T cell responses [53]. Furthermore, the development of fibrin clots alters the tumor immune microenvironment and may further inhibit immune response by presenting a physical barrier for infiltrating immune cells [54]. On the other hand, sustained inflammation has been associated with CAT and tumor metastasis in preclinical lung cancer models, including by the formation of neutrophil extracellular traps [55], which have been implicated in venous and arterial thrombosis as a response to inflammation [56].…”

Section: Immune Checkpoint Blockadementioning

confidence: 99%

Lung Cancer Related Thrombosis (LCART): Focus on Immune Checkpoint Blockade

Charpidou,

Gerotziafas,

Popat

et al. 2024

Cancers

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Cancer-associated thrombosis (CAT) is a common complication in lung cancer patients. Lung cancer confers an increased risk of thrombosis compared to other solid malignancies across all stages of the disease. Newer treatment agents, including checkpoint immunotherapy and targeted agents, may further increase the risk of CAT. Different risk-assessment models, such as the Khorana Risk Score, and newer approaches that incorporate genetic risk factors have been used in lung cancer patients to evaluate the risk of thrombosis. The management of CAT is based on the results of large prospective trials, which show similar benefits to low-molecular-weight heparins (LMWHs) and direct oral anticoagulants (DOACs) in ambulatory patients. The anticoagulation agent and duration of therapy should be personalized according to lung cancer stage and histology, the presence of driver mutations and use of antineoplastic therapy, including recent curative lung surgery, chemotherapy or immunotherapy. Treatment options should be evaluated in the context of the COVID-19 pandemic, which has been shown to impact the thrombotic risk in cancer patients. This review focuses on the epidemiology, pathophysiology, risk factors, novel predictive scores and management of CAT in patients with active lung cancer, with a focus on immune checkpoint inhibitors.

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The role of coagulome in the tumor immune microenvironment

Cited by 5 publications

References 196 publications

Evaluation of perioperative routine coagulation testing versus thromboelastography for major liver resection – A single-arm, prospective, interventional trial (PORTAL trial)

Evaluation of perioperative routine coagulation testing versus thromboelastography for major liver resection – A single-arm, prospective, interventional trial (PORTAL trial)

Efficacy of mFOLFOX6 plus bevacizumab regimen in advanced colorectal cancer after deep hyperthermia: a single-center retrospective study

Lung Cancer Related Thrombosis (LCART): Focus on Immune Checkpoint Blockade

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