Influence of low molecular weight heparin on cancer patients’ survival

• Main Author: V. V. Ptushkin
• Format: Article
• Language: Russian
• Published: ABV-press 2014-07-01
• Series: Onkogematologiâ
• Subjects: ultra low molecular weight heparins; low molecular weight heparins; cancer; metastasis; survival
• Online Access: http://oncohematology.abvpress.ru/index.php/ongm/article/view/36

<p>There is an evidence of interaction between the hemostasis system and tumor progression factors. It is known that in addition to the fibrin formation and platelets activation, thrombin can influence many cells function interacting with protease-activating receptors including tumor cells. These receptors are involved in the malignant cell phenotype formation (adhesion, proliferation, proteolysis). Thrombin can also affect angiogenesis by stimulating endothelial cells penetration through basal membrane and its migration with new vessels formation. Furthermore, it can cause the release of main neoangiogenesis promoter – vascular endothelial growth factor. All of the above and many other linkages of coagulation and tumor create a theoretical background of possible affecting tumor by regulation of the coagulation activity. The<br />promise of this approach is controversial, but there is some clinical and experimental evidence of their effectiveness. The most used group of<br />drugs for this purpose was heparins. Several retrospective studies have shown a benefit of low molecular weight heparins (LMWH) over unfractionated heparin in cancer patient survival. The appearance of a new heparins group – ultra LMWH are of interest from this point of<br />view and their possible use in cancer patients. To date bemiparin and semuloparin are used in clinic. Both (bemiparin about 3600 kDa,<br />semuloparin 3000 kDa) have substancially reduced molecular weight as compared with the smallest of LMWH – enoxaparin (4600 kDa).<br />Use of bemiparin in patients with small cell lung cancer receiving chemotherapy resulted in increased of 2-year survival rate compared to the control group (68.6 % vs. 29.4 %, p = 0.0042).</p>