Platelets and Cancer

Dear Colleagues,

Platelets, cytoplasmic fragments of megakaryocytes, are characterized by the absence of a nucleus and the presence of various granules (α-granules, dense granules, and lysosomes). These cell fragments are known for the role played in hemostasis and thrombosis. Platelet activation and aggregation, and the secretion of lipids, including thromboxane(TX)A₂, and their granule content [rich in pro-aggregatory molecules like adenosine diphosphate (ADP)] are key events for clotting formation and stop bleeding. Moreover, to their central role in hemostasis and thrombosis platelets are implicated in: (i) inflammation; (ii) immune function; and (iii) pathogenic mechanisms, e.g., atherothrombosis, cancer and metastasis.

The role of platelets in cancer, particularly in tumor metastasis, was first suggested a long time ago, but convincing evidence was recently provided by the analyses of the vast amount of clinical information from placebo-controlled randomized clinical trials (RCTs) with aspirin for cardiovascular prevention.  The evidence was considered appropriate to recommend aspirin use for the primary prevention of cardiovascular disease and cancer by the U.S. Preventive Services Task Force.

The clinical data showing the efficacy of the antiplatelet agent aspirin as an anticancer agent, have catalyzed the work of researchers with different expertise who have uncovered the multifaceted roles played by platelets in tumor development and metastatic dissemination. Platelets act through the crosstalk with stromal cells and cancer cells mediated by the release of several soluble mediators and vesicles, including microparticles.

The biomedical research should exploit the new knowledge on the role of platelets in cancer and focus on the development of safer antiplatelet drugs that interfere with the molecular mechanisms involved in the crosstalk of platelets with the cells of the microenvironment and/or tumor cells. These new pharmacological agents may potentially stop cancer at the earliest stages of development, thus preventing tumor metastasis. Finally, the recent knowledge of the role of platelets in tumor immune escape opens the way to novel strategies to fight cancer based on the use of antiplatelet agents.

The evaluation of proteomics and transcriptomics signature of platelets and platelet-derived microparticles could represent a new strategy for the development of biomarkers for early cancer detection and/or therapeutic drug monitoring in cancer chemotherapy.

Due to the ability of platelets to interact with cancer cells and to deliver their cargo, platelets have been proposed as a “biomimetic drug delivery system” for anti-tumor drugs to prevent the occurrence of off-target adverse events associated with the use of traditional chemotherapy.

Prof. Dr. Paola Patrignani
Dr. Annalisa Bruno
Dr. Melania Dovizio
Guest Editors

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