![]() ![]() Cancer and platelet crosstalk: opportunities and challenges for aspirin and other antiplatelet agents. This paper shows that ovarian tumour cells secrete IL-6, which increases hepatic thrombopoietin production and promotes platelet generation. Paraneoplastic thrombocytosis in ovarian cancer. Cooperation between constitutive and inducible chemokines enables T cell engraftment and immune attack in solid tumors. Contribution of platelets to tumour metastasis. Platelets and fibrin(ogen) increase metastatic potential by impeding natural killer cell-mediated elimination of tumor cells. In ovarian cancer multicellular spheroids, platelet releasate promotes growth, expansion of ALDH + and CD133 + cancer stem cells, and protection against the cytotoxic effects of cisplatin, carboplatin and paclitaxel. Platelets subvert T cell immunity against cancer via GARP-TGFβ axis. Platelet-derived MHC class I confers a pseudonormal phenotype to cancer cells that subverts the antitumor reactivity of natural killer immune cells. This paper shows that platelets promote epithelial-to-mesenchymal-like transition of cancer cells through both contact-dependent and contact-independent mechanisms. Direct signaling between platelets and cancer cells induces an epithelial-mesenchymal-like transition and promotes metastasis. Platelets increase the proliferation of ovarian cancer cells. Paraneoplastic thrombocytosis: the secrets of tumor self-promotion. Thrombocytosis associated with malignant disease. Patrolling the vascular borders: platelets in immunity to infection and cancer. Platelet biology and functions: new concepts and clinical perspectives. We also provide our view on how to overcome challenges faced by the development of precise antiplatelet strategies for safe and efficient clinical cancer therapy. In this Review, we present a detailed picture of the dynamic roles of platelets in tumour development and progression as well as their use in diagnosis, prognosis and monitoring response to therapy. This has led to the identification of the biological changes in platelets in the presence of tumours, the complex interactions between platelets and tumour cells during tumour progression, and the effects of platelets on antitumour therapeutic response. Recent work has advanced our understanding of the molecular mechanisms responsible for the contribution of platelets to tumour progression and metastasis. However, until recently, targeting platelets as a cancer therapeutic has been hampered by the elevated risk of haemorrhagic and thrombocytopenic (low platelet count) complications owing to the lack of specificity for tumour-associated platelets. Systemic antiplatelet treatment represents a promising option to improve the therapeutic outcomes and therapeutic efficacy of chemotherapy and immunotherapy due to the critical contribution of platelets to tumour progression.
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