Cancer-Associated Thrombosis (CAT); mechanisms and treatment options

Fahad S Alshehri; Abdurahman Alloghbi; Abdulrahman Alshalani; Hassan Abu Sabah; Claire S Whyte

doi:10.1186/s12959-025-00795-9

Cancer-Associated Thrombosis (CAT); mechanisms and treatment options

Thromb J. 2025 Nov 24;23(1):116. doi: 10.1186/s12959-025-00795-9.

Authors

Fahad S Alshehri^{1

2}, Abdurahman Alloghbi³, Abdulrahman Alshalani⁴, Hassan Abu Sabah⁵, Claire S Whyte⁶

Affiliations

¹ King Faisal Medical City for Southern Region, Pathology and Clinical Laboratory Medicine Department, Haematology Division, Abha, Saudi Arabia. fsalshehrii@kfmcity.med.sa.
² King Fahad Medical City, Pathology and Clinical Laboratory Medicine Department, Haematology Division, Riyadh, Saudi Arabia. fsalshehrii@kfmcity.med.sa.
³ Department of Oncology, College of Medicine, King Khalid University, Abha, Saudi Arabia.
⁴ Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
⁵ King Faisal Medical City for Southern Region, Pathology and Clinical Laboratory Medicine Department, Haematology Division, Abha, Saudi Arabia.
⁶ Aberdeen Cardiovascular & Diabetes Centre, School of Medicine, Medical Science and Nutrition, Institute of Medical Science, University of Aberdeen, Aberdeen, UK.

Abstract

Cancer-associated thrombosis (CAT), especially venous thromboembolism (VTE), is the second highest cause of mortality in cancer patients, following the cancer itself. Notably, among patients with thrombosis, cancer is the most common underlying cause of death, highlighting the strong interrelationship between these conditions. Tumour cells primarily promote a prothrombotic environment through activation of procoagulant properties of the host cells. Additionally, chemotherapy, radiotherapy and hormone treatments may amplify the thrombotic risk in cancer patients. Consequently, both arterial thromboses, including myocardial infarction (MI) and ischemic stroke (IS), and venous thrombosis, such as deep vein thrombosis (DVT) and pulmonary embolism (PE), are significantly more prevalent among patients with malignancies. This review will discuss the association between cancer and thrombosis, illustrate the most common risk factors and discuss the direct and indirect molecular mechanisms involved.

Keywords: Arterial thrombosis; Cancer; Platelets; Tumour cells; Venous thrombosis.

Publication types

Review