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Effect of all‐trans ‐Retinoic acid on the hypercoagulable state of patients with breast cancer
Author(s) -
Falanga A.,
Toma S.,
Marchetti M.,
Palumbo R.,
Raffo P.,
Consonni R.,
Marziali S.,
Dastoli G.,
Barbui T.
Publication year - 2002
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.10073
Subject(s) - medicine , breast cancer , fibrinolysis , tamoxifen , cancer , coagulation , gastroenterology , factor vii , retinoic acid , d dimer , oncology , endocrinology , biochemistry , chemistry , gene
To evaluate whether all‐trans ‐retinoic acid (ATRA) is able to modulate the hemostatic system in patients with solid tumors, we studied patients with locally advanced breast cancer who were enrolled in a Phase Ib study of ATRA ± Tamoxifen (Tam). In this study, two groups of 15 patients/each were treated for 21 days before operation with ATRA at three doses (15, 45, or 75 mg/m 2 /day on alternate days) given alone (group 1) or in combination with Tam (group 2). One additional group received Tam alone. Plasma samples were evaluated for hypercoagulation markers (FVIIa, F1+2, TAT, D‐dimer), fibrinolysis proteins (t‐PA, PAI‐1), and coagulation inhibitors (protein C, AT). At baseline, cancer patients had FVIIa, F1+2, TAT, and PAI‐1 significantly greater than control subjects. During treatment, in the patients given ATRA alone, hypercoagulation markers appeared unmodified. Instead, subjects given Tam alone had a significant elevation of FVIIa, F1+2, and TAT versus baseline. However, in the ATRA + Tam groups, hypercoagulation markers were decreased compared with Tam alone. These results suggest that in selected conditions, pre‐operative ATRA may modulate the hypercoagulable state of breast cancer patients. Am. J. Hematol. 70:9–15, 2002. © 2002 Wiley‐Liss, Inc.