Biomarkers, association, and prediction in cancer-associated thrombosis and bleeding

“We would also like to acknowledge the important distinction between association vs prediction. We agree that future research in cancer-associated thrombosis risk stratification will likely require more integrated and dynamic approaches incorporating clinical variables, biomarkers, and potentially cancer-specific characteristics. Longitudinal biomarker assessment to correlate with dynamic thrombotic and bleeding risks in patients with cancer is also a major knowledge gap in this area.”

“Future studies exploring the biologic pathways linking these biomarkers with thrombosis and bleeding may provide important mechanistic insight, particularly given the complex interplay between inflammation, physiologic stress, cancer progression, treatment exposures, and patient comorbidity, all of which can contribute to thrombotic and bleeding risks in cancer populations.”

“Finally, we agree with the importance of considering thrombosis and bleeding risk together rather than independently. Differential biomarker associations with VTE and bleeding may help generate hypotheses regarding distinct biologic pathways and may also help inform future efforts aimed at integrated risk–benefit stratification.”