Coagulation Abnormalities in Lung Cancer: Diagnostic Challenges and Therapeutic Perspectives
Lung cancer is frequently complicated by coagulation abnormalities, primarily presenting as venous thromboembolism (VTE) but also including bleeding events in select patients. This hypercoagulable state arises from a multifaceted interplay between tumor-derived procoagulants, systemic inflammation,...
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| Format: | Article |
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SAGE Publishing
2025-08-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/10760296251359293 |
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| author | Athena Myrou MD, MSc, PhD Athanasios Penopoulos MD Konstantinos Barmpagiannos MD Styliani Ouzouni MD Fotios Girtovitis MD, PhD |
| author_facet | Athena Myrou MD, MSc, PhD Athanasios Penopoulos MD Konstantinos Barmpagiannos MD Styliani Ouzouni MD Fotios Girtovitis MD, PhD |
| author_sort | Athena Myrou MD, MSc, PhD |
| collection | DOAJ |
| description | Lung cancer is frequently complicated by coagulation abnormalities, primarily presenting as venous thromboembolism (VTE) but also including bleeding events in select patients. This hypercoagulable state arises from a multifaceted interplay between tumor-derived procoagulants, systemic inflammation, endothelial dysfunction, autoimmune mechanisms, and treatment-associated effects. These disruptions not only elevate thrombotic risk but also influence prognosis and therapeutic decisions. Furthermore, the presence of antiphospholipid antibodies or acquired coagulation inhibitors, such as lupus anticoagulant and anti-Factor VIII antibodies, poses a unique clinical challenge by increasing the risk of both thrombosis and hemorrhage. Recent data highlight the expanding role of tumor-derived extracellular vesicles, immune-mediated coagulopathies, and prothrombotic effects of immune checkpoint inhibitors in lung cancer–associated thrombosis. Novel biomarkers-such as prothrombin fragment 1 + 2, integrin β2– positive extracellular vesicles, and endothelial activation markers-are being investigated for risk stratification and personalized treatment decisions. Diagnostic approaches-including coagulation assays, biomarker profiling, and imaging-are discussed alongside emerging tools for individualized anticoagulation and management of acquired inhibitors. Early recognition and tailored management of cancer-associated coagulopathy are essential to improve patient outcomes. This review aims to provide practical insights for clinicians navigating the thrombohemorrhagic spectrum in lung cancer care. |
| format | Article |
| id | doaj-art-ea03997fdf184e0f979f9c14e9cc343c |
| institution | Kabale University |
| issn | 1938-2723 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | SAGE Publishing |
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| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj-art-ea03997fdf184e0f979f9c14e9cc343c2025-08-20T03:44:17ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232025-08-013110.1177/10760296251359293Coagulation Abnormalities in Lung Cancer: Diagnostic Challenges and Therapeutic PerspectivesAthena Myrou MD, MSc, PhD0Athanasios Penopoulos MD1Konstantinos Barmpagiannos MD2Styliani Ouzouni MD3Fotios Girtovitis MD, PhD4 Department of Internal Medicine, AHEPA , Aristotle University of Thessaloniki, Thessaloniki, Greece Department of Internal Medicine, AHEPA , Aristotle University of Thessaloniki, Thessaloniki, Greece Department of Internal Medicine, AHEPA , Aristotle University of Thessaloniki, Thessaloniki, Greece Department of Internal Medicine, AHEPA , Aristotle University of Thessaloniki, Thessaloniki, Greece National Blood Center Unit, AHEPA , Aristotle University of Thessaloniki, Thessaloniki, GreeceLung cancer is frequently complicated by coagulation abnormalities, primarily presenting as venous thromboembolism (VTE) but also including bleeding events in select patients. This hypercoagulable state arises from a multifaceted interplay between tumor-derived procoagulants, systemic inflammation, endothelial dysfunction, autoimmune mechanisms, and treatment-associated effects. These disruptions not only elevate thrombotic risk but also influence prognosis and therapeutic decisions. Furthermore, the presence of antiphospholipid antibodies or acquired coagulation inhibitors, such as lupus anticoagulant and anti-Factor VIII antibodies, poses a unique clinical challenge by increasing the risk of both thrombosis and hemorrhage. Recent data highlight the expanding role of tumor-derived extracellular vesicles, immune-mediated coagulopathies, and prothrombotic effects of immune checkpoint inhibitors in lung cancer–associated thrombosis. Novel biomarkers-such as prothrombin fragment 1 + 2, integrin β2– positive extracellular vesicles, and endothelial activation markers-are being investigated for risk stratification and personalized treatment decisions. Diagnostic approaches-including coagulation assays, biomarker profiling, and imaging-are discussed alongside emerging tools for individualized anticoagulation and management of acquired inhibitors. Early recognition and tailored management of cancer-associated coagulopathy are essential to improve patient outcomes. This review aims to provide practical insights for clinicians navigating the thrombohemorrhagic spectrum in lung cancer care.https://doi.org/10.1177/10760296251359293 |
| spellingShingle | Athena Myrou MD, MSc, PhD Athanasios Penopoulos MD Konstantinos Barmpagiannos MD Styliani Ouzouni MD Fotios Girtovitis MD, PhD Coagulation Abnormalities in Lung Cancer: Diagnostic Challenges and Therapeutic Perspectives Clinical and Applied Thrombosis/Hemostasis |
| title | Coagulation Abnormalities in Lung Cancer: Diagnostic Challenges and Therapeutic Perspectives |
| title_full | Coagulation Abnormalities in Lung Cancer: Diagnostic Challenges and Therapeutic Perspectives |
| title_fullStr | Coagulation Abnormalities in Lung Cancer: Diagnostic Challenges and Therapeutic Perspectives |
| title_full_unstemmed | Coagulation Abnormalities in Lung Cancer: Diagnostic Challenges and Therapeutic Perspectives |
| title_short | Coagulation Abnormalities in Lung Cancer: Diagnostic Challenges and Therapeutic Perspectives |
| title_sort | coagulation abnormalities in lung cancer diagnostic challenges and therapeutic perspectives |
| url | https://doi.org/10.1177/10760296251359293 |
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