Abstract
The role of platelets in cancer progression has been well recognized in the field of cancer biology. Emerging studies are elaborating further the additional roles and added extent that platelets play in promoting tumorigenesis. Platelets release factors that support tumor growth and also form heterotypic aggregates with tumor cells, which can provide an immune-evasive advantage. Their most critical role may be the inhibition of immune cell function that can negatively impact the body’s ability in preventing tumor establishment and growth. This review summarizes the importance of platelets in tumor progression, therapeutic response, survival, and finally the notion of immunotherapy modulation being likely to benefit from the inclusion of platelet inhibitors.
Highlights
Platelets arise from immune stem cell lineages in the bone marrow that are critically important in blood clotting and wound healing [1, 2]
The inhibition of cyclooxygenase 2 (COX-2) was shown to negatively impact immune evasion of tumor cells, as its inhibition was shown to synergize with programmed death-ligand 1 (PD-L1) blockade suggesting that COX inhibitors could be used in combination with immunotherapy [170]
Strong experimental and clinical evidence supports an active involvement of platelets in tumorigenesis and metastasis
Summary
Platelets arise from immune stem cell lineages in the bone marrow that are critically important in blood clotting and wound healing [1, 2]. Even the thrombi formed for the resolution of the wounds may cause thromboembolic complications [3] Cancer is one such disease that can disrupt the normal functioning and production of platelets which in part is contributed by the pro-carcinogenic inflammatory milieu. High platelet counts in these patients correlated with tumor invasiveness, metastasis, and worse survival outcomes [9,10,11,12,13]. It appears that platelets increase in numbers and get activated with cancer progression and return to their normal levels and functional state following cancer therapy. Platelet release reactions factors provide growth factors and metalloproteinases involved in tissue reorganization [60,61,62] and have found clinical use in platelet-rich plasma therapy [60, 63,64,65,66]
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