Monitoring circulating platelet activity to predict cancer-associated thrombosis

A characteristic clinical complication in cancer patients is the frequent incidence of thrombotic events. Numerous studies have shown hyperactive/activated platelets to be a critical earlier trigger for cancer-associated thrombus formation. However, there currently is no viable approach to monitor specific changes in tumor-associated platelet activity. Here, we describe a chromatograph-like microfluidic device that is highly sensitive to the activity status of peripheral circulating platelets in both tumor-bearing mice and clinical cancer patients. Our results show a strongly positive correlation between platelet activation status and tumor progression. Six-month follow-up data from advanced cancer patients reveal positive links between platelet activity level and thrombus occurrence rate, with a high predictive capacity of thrombotic events (AUC = 0.842). Our findings suggest that circulating platelet activity status determined by this microfluidic device exhibits sensitive, predictive potential for thrombotic events in cancer patients for directing well-timed antithrombosis treatment. [Display omitted] •A microfluidic device effectively detects tumor-associated platelet hyperactivity•Platelet activation status is correlated with cancer progression and thrombotic risk•The device predicts thrombotic events in advanced lung, breast, and liver cancer•This approach can guide timely antithrombotic therapy in cancer patients Cancer patients often face thrombosis due to platelet hyperactivity, impacting their prognosis. Yet, we lack a simple, sensitive method to analyze their blood coagulation status. To address this concern, our study aims to develop a microfluidic device for detecting platelet activation. It offers improved sensitivity, time-efficient measurements, user-friendly operation, and cost-effective design. This device is envisioned to enhance thrombotic disease management in cancer patients and facilitate more accurate and accessible coagulation analysis in clinical and research settings. Li et al. introduce a microfluidic device that offers a fast, cost-effective method for tracking platelet activation in cancer patients. They demonstrate a strong correlation between elevated platelet activity, tumor progression, and thrombosis risk. This device can help to enable timely and targeted antithrombotic treatment.