Figure 5.

Inhibition of cancer progression by dabigatran etexilate. Thrombin has many activities that can support cancer progression and metastasis including fibrin deposition, PAR-1 activation (stimulating tumor cell proliferation), and platelet activation. Thrombin can induce TGF-β both via the release of TGF-β from activated platelets and via the release of latent TGF-β from extracellular matrix stores. Tumor cells also produce large amounts of TGF-β which strongly impacts the generation and expansion of myeloid derived suppresser cells (MDSC) that contribute to an immunosuppressive microenvironment. Dabigatran etexilate directly inhibits thrombin, potentially disrupting many of these protumorigenic pathways.