Are biomarkers useful in thrombotic risk assessment in oncologic patients?

Introduction Primary and recurrent venous thromboembolism–persists as a source of major morbidity and mortality. Although frequent in general population, the incidence of venous thromboembolism among oncologic patients is roughly higher, and expected to keep rising not only due to prevalence of cancer and the ageing of occidental population, but also due to an enhanced detection of incidental thrombosis during follow-up and the thrombogenecity of some chemotherapeutic regimens. Because of the potential life-threatening nature of venous thromboembolism, oncologic patients might benefit from thromboprophylaxis. Therefore, in the last years, efforts have been made to help clinicians in the prevention and management of thrombotic events in cancer patients. In this way, some biomarkers have been used to create stratification risk scores, joined with clinical characteristics, and in this review we pursue to demonstrate the main thrombotic risk biomarkers related to cancer. Conclusion The widely used Khorana risk assessment model has been expanded by adding sP-selectin and D-dimer. Other biomarkers showing some improvement in thrombotic risk assessment as factor VIII (with a dose-related increased risk), elevated peak thrombin (defined as thrombin values = 611 nM), tissue factor or C-reactive protein have yielded promising results. However, the absence of widespread clinical availability of tests measuring these biomarkers, the lack of standardisation and their cost make their implementation in daily practice difficult.