Biomarker Predicts Blood Clots in Cancer Patients

A prediction model for the risk of venous thromboembolism (VTE) in cancer patients should include the biomarker soluble P-selectin (sP-selectin) molecules.

The level of sP-selectin in platelet poor plasma can be assayed using an immunoassay. Soluble P-selectin is a member of the selectin family of cell adhesion molecules and is found in the granules of platelets and the Weibel-Palade bodies of endothelial cells. It is expressed on the cell surface on activation, mediates the adhesion of leukocytes, platelets, and cancer cells in inflammation, thrombosis, and cancer growth and metastasis.

In a recent study, scientists examined sP-selectin levels in 819 cancer patients enrolled in an ongoing prospective observational study performed between October 2003 and December 2008 at the Medical University of Vienna, (Vienna, Austria). They were 365 participants with newly diagnosed malignant disease and 322 whose disease had progressed after complete or partial remission. Cancer types included brain, breast, lung, stomach, colorectal, pancreatic, kidney, prostate, and hematological malignancies such as myeloma and lymphoma. All patients were prospectively followed for a median of 415 days. Levels of the biomarker were measured using a human sP-selectin Immunoassay, a product of R&D Systems (Minneapolis, MN, USA).

The results of the study show that cancer patients can be divided into high- and low-risk groups of developing VTE. The cumulative probability of VTE in the total study population was 5.5% after six months and 6.8% after one year. SP-selectin levels were statistically significantly higher among cancer patients with VTE, whose median level was 45.9 ng/mL, (interquartile range (IQR): 35.4-62.8 ng/mL). Among those without VTE, the median was 42.1 ng/mL, (IQR: 32.9-52.2 ng/mL). Results from this study found that 7.2% of lymphoma patients and 7.4% of the total study population developed VTE, compared to an estimated general population incidence rate of 0.001%.

Ingrid Pabinger, M.D., lead author of the study, said," Because the risk of VTE is not equal in all cancer patients and anticoagulation in cancer patients results in a higher risk of bleeding complications, categorizing cancer patients according to their VTE risk is important." This new model can help clinicians tailor their anticoagulant therapy and improve blood clotting prevention, which will maximize the clinical benefit and cost-effectiveness of disease prevention and minimize the risk of bleeding complications. The study was published on line in September 2010 in the journal Blood.

Related Links:
Medical University of Vienna
R&D Systems