Figure 2.

Indirect mechanisms promoting thrombosis in cancer. Tumours can be highly metastatic, resulting in cancer cell dissemination and intravasation into nearby blood vessels. Inflammatory cytokine secretion from tumour cells can cause activation of platelets and promote a procoagulant phenotype in endothelial cells. Cancer-derived factors also stimulate neutrophils to release neutrophil extracellular traps (NETs). NETs serve as a scaffold that can physically entrap platelets, or activate platelets through NET-associated histones, ultimately leading to profound platelet activation, fibrin deposition, and entrapment of red blood cells, exacerbating clot formation.