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document
Weight-adjusted dalteparin for prevention of vascular thromboembolism in advanced pancreatic cancer patients decreases serum tissue factor and serum-mediated induction of cancer cell invasion . The aim of the present study was to assess the role of tissue factor and serum-induced cell invasion in patients with advanced pancreatic cancer ( APC ) . A cohort of 39 patients with APC , without thrombosis , receiving chemotherapy , were entered in a randomized controlled trial ( ISRCTN = 76464767 ) of thromboprevention with weight-adjusted dalteparin ( WAD ) . A total of 19 patients received WAD , the remaining 20 acting as a control group . Serum from baseline and week 8 was analysed for circulating-tissue factor antigen using ELISA . Circulating-tissue factor antigen rose from 324 pg/ml , [ interquartile range ( IQR ) 282-347 pg/ml ] to 356 pg/ml , ( IQR 319-431 pg/ml ) in controls ( C ) , and decreased in the dalteparin-treated group ( D ) from 336 pg/ml ( IQR 281-346 pg/ml ) to 303 pg/ml ( IQR 274-339 pg/ml ) . The difference in median percentage change between D and C was statistically significant [ -4.0 ( D ) vs. 4.7 ( C ) ; P = 0.005 , n = 39 ] . Serum-induced cellular invasion of MIA-Paca-2 cells in response to patient serum was studied using a Boyden chamber assay in 30 patients ( 14 WAD and 16 C ) . The median percentage change between C and D was significant [ +54.9 ( C ) vs. -21.9 ( D ) P = 0.025 , n = 30 ] . There was a weak correlation between BB-tissue factor reduction and cellular invasion reduction ( Spearman ) [ 0.384 ( P = 0.037 , n = 30 ) ] . APC patients treated with WAD have lower tissue factor antigen levels and attenuated induction of cellular invasion in their blood . These assays may provide useful markers to guide appropriate dalteparin ( and other low-molecular weight heparin ) dosing schedules to optimize anticancer effects of dalteparin in APC .
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Intervention_Pharmacological
dalteparin
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Intervention_Physical
chemotherapy
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Intervention_Pharmacological
thromboprevention with weight-adjusted dalteparin
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Intervention_Pharmacological
WAD
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Intervention_Control
control group
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Outcome_Physical
vascular thromboembolism
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Outcome_Physical
serum tissue factor and serum-mediated induction of cancer cell invasion
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Outcome_Physical
advanced pancreatic cancer
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Outcome_Physical
Circulating-tissue factor antigen
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Outcome_Physical
Serum-induced cellular invasion of MIA-Paca-2 cells
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Outcome_Other
median percentage change
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Outcome_Physical
lower tissue factor antigen levels and attenuated induction of cellular invasion in their blood
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Outcome_Other
anticancer effects
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Participant_Condition
advanced pancreatic cancer patients
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Participant_Condition
patients with advanced pancreatic cancer ( APC )
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Participant_Sample-size
39 patients
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Participant_Condition
thrombosis , receiving chemotherapy
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Participant_Condition
APC patients treated