+1 Recommend
0 collections
      • Record: found
      • Abstract: found
      • Article: not found

      Local blood coagulation drives cancer cell arrest and brain metastasis in a mouse model

      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.


          Clinically relevant brain metastases (BM) frequently form in cancer patients, with limited options for effective treatment. Circulating cancer cells must first permanently arrest in brain microvessels to colonize the brain, but the critical factors are not well understood. Here, in vivo multiphoton laser-scanning microscopy (MPLSM) of the entire brain metastatic cascade allowed unprecedented insights into how blood clot formation and von Willebrand factor (VWF) deposition determine the arrest of circulating cancer cells and subsequent brain colonization in mice. Clot formation in brain microvessels occurred frequently (>95%) and specifically at intravascularly arrested cancer cells, allowing their long-time arrest. An extensive clot embedded approximately 20% of brain-arrested cancer cells, and those were more likely to successfully extravasate and form a macrometastasis. Mechanistically, tissue factor-mediated thrombin generation by cancer cells accounted for local activation of plasmatic coagulation in the brain. Thrombin inhibition by treatment with low-molecular weight heparin or dabigatran and an anti-VWF antibody prevented clot formation, cancer cell arrest, extravasation, and brain macrometastasis formation. In contrast, tumor cells were not able to directly activate platelets, and antiplatelet treatments did reduce platelet dispositions at intravascular cancer cells but did not reduce overall BM formation. In conclusion, our data shows that plasmatic coagulation is activated early by intravascular tumor cells in the brain, with subsequent clot formation, discovering a novel and specific mechanism that is crucial for brain colonization. Direct or indirect thrombin and VWF inhibitors emerge as promising drug candidates for BM prevention trials.

          Related collections

          Author and article information

          (View ORCID Profile)
          (View ORCID Profile)
          (View ORCID Profile)
          (View ORCID Profile)
          (View ORCID Profile)
          (View ORCID Profile)
          (View ORCID Profile)
          American Society of Hematology
          December 03 2020
          December 03 2020
          [1 ]Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
          [2 ]Dermatology, Hamburg, Germany
          [3 ]Division of Oncology, Department of Medicine I, Medical University of Vienna, Austria
          [4 ]Department of Dermatology and Venereology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
          [5 ]Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany, Germany
          [6 ]Business Unit Service and Customer Care, Carl Zeiss Microscopy GmbH, 07745 Jena,, Germany
          [7 ]Department of Dermatology and Venereology, University Hospital Hamburg Eppendorf, Hamburg, Germany, Germany
          [8 ]Heidelberg University Hospital, Heidelberg, Germany
          [9 ]University Hospital Heidelberg
          [10 ]Department of Endocrinology and Clinical Chemistry, Medical University Hospital, Heidelberg, Germany, Germany
          [11 ]European Molecular Biology Laboratory, Heidelberg, Germany
          [12 ]University Hospital Hamburg-Eppendorf, Hamburg, Germany, Hamburg, Germany
          © 2020


          Comment on this article