A systematic review on the effects of direct oral anticoagulants on cancer growth and metastasis in animal models

Background: Direct oral anticoagulants (DOACs) are now the first choice thromboprophylaxis in cancer patients who do not have a high risk of bleeding. In addition to the anticoagulant effects, potential anti-tumor effects of DOACs have also been studied in animal cancer models. In this study, we summarize the effects of DOACs on cancer growth and metastasis in animal models through a systematic review with a qualitative analysis.Methods: PubMed, EMBASE and Web of Science were systematically searched for original studies that describe animal models of cancer in which one of the experimental groups received DOAC monotherapy, and which reported quantitatively on primary tumor or metastases.Results: Nine studies - reporting a total of 19 animal experiments - met the inclusion criteria. These 19 experiments included spontaneous cancer (n = 2), carcinogenicity (n = 2), xenograft (n = 7) and syngeneic (n = 8) models, encompassing orthotopic (n = 7), subcutaneous (n = 5), intraperitoneal (n = 1) and intravenous (n = 2) injection of cancer cells and included treatments with the DOACs ximelagatran (n = 4), dabigatran etexilate (n = 6) and/or rivaroxaban (n = 11). DOAC treatment decreased tumor growth at implanted and metastatic site in 18.8% (3/16) and 20.0% (3/15) of the experiments, respectively. Conversely, DOACs increased tumor growth at implanted and metastatic site in 6.3% (1/16) and 20.0% (3/15) of the experiments, respectively.Conclusion: DOAC monotherapy resulted in neoplastic changes in a rat carcinogenicity study, showed a lack of effect in mouse xenograft models, while the effect on cancer growth and metastasis in mouse syngeneic models depended on the timing of DOAC treatment and type of cancer model used.Thrombosis and Hemostasi

Molecular advances in cutaneous T-cell lymphoma

Dermatology-oncolog

Improved Sezary cell detection and novel insights into immunophenotypic and molecular heterogeneity in Sezary syndrome

Sezary syndrome (SS) is an aggressive leukemic form of cutaneous T-cell lymphoma with neoplastic CD4(+) T cells present in skin, lymph nodes, and blood. Despite advances in therapy, prognosis remains poor, with a 5-year overall survival of 30%. The immunophenotype of Sezary cells is diverse, which hampers efficient diagnosis, sensitive disease monitoring, and accurate assessment of treatment response. Comprehensive immunophenotypic profiling of Sezary cells with an in-depth analysis of maturation and functional subsets has not been performed thus far. We immunophenotypically profiled 24 patients with SS using standardized and sensitive EuroFlow-based multiparameter flow cytometry. We accurately identified and quantified Sezary cells in blood and performed an in-depth assessment of their phenotypic characteristics in comparison with their normal counterparts in the blood CD4(+) T-cell compartment. We observed inter- and intrapatient heterogeneity and phenotypic changes over time. Sezary cells exhibited phenotypes corresponding with classical and nonclassical T helper subsets with different maturation phenotypes. We combined multiparameter flow cytometry analyses with fluorescence-activated cell sorting and performed RNA sequencing studies on purified subsets of malignant Sezary cells and normal CD4(+) T cells of the same patients. We confirmed pure monoclonality in Sezary subsets, compared transcriptomes of phenotypically distinct Sezary subsets, and identified novel downregulated genes, most remarkably THEMIS and LAIR1 , which discriminate Sezary cells from normal residual CD4(+) T cells. Together, these findings further unravel the heterogeneity of Sezary cell subpopulations within and between patients. These new data will support improved blood staging and more accurate disease monitoring.Stemcel biology/Regenerative medicine (incl. bloodtransfusion