Cancer patients are at increased risk of thrombotic complications, especially venous
thromboembolism (VTE). The oncology population is seven times more likely to develop
thrombosis when compared to the general population, with an incidence of up to 20% of
patients during follow-up. It is suggested that the reasons for this greater thrombotic
risk are immobility, invasive procedures and changes in coagulation, in addition to
possible disorders of platelet aggregation and endothelial function.
The literature suggests that the basic thromboembolic mechanism would be related to the
production, by tumor cells, of pro-coagulant factors such as tissue factor and neoplastic
pro-coagulant. PAI-1, the main inhibitor of the plasminogen activator pathway, is also
produced by tumor cells. Still, tumor production of factors inhibiting the fibrinolytic
system plays a role in hypercoagulability and may contribute to tumor angiogenesis.
Regarding arterial thrombotic events, although there is no unanimity regarding the causal
relationship between the pathologies, epidemiological data strongly suggest that this
complication is more common in patients with cancer, compared to the population without
the disease.
It is worth mentioning that lung cancer is the most common cause of cancer deaths in the
world. It is possible that the high mortality from lung cancer is related, at least
partially, to the higher incidence of thrombotic complications presented by these
patients, compared to those with other types of cancer. Although VTE is one of the main
causes of morbidity and mortality in cancer patients, the use of anticoagulants as
primary prophylaxis is not routinely recommended.
The pathophysiological mechanisms involved in the increased risk of thromboembolic events
in cancer patients, especially with lung cancer, which, as mentioned, present, in
addition to the aggressiveness of the disease itself, a higher incidence of thrombotic
events, are still little known. The main objective of this project is to contribute to a
better understanding of the mechanisms involved in thrombotic events in the population
with lung cancer, with clear therapeutic impacts.
This is a case-control study with groups differentiated by the presence or absence of
NSCLC and matched by age, sex and presence or absence of smoking in the 6 months prior to
inclusion. Patients diagnosed with NSCLC without prior treatment for the disease will be
candidates for participation in the study.
The primary objective is to compare platelet aggregability by optical aggregometry
assessed by the AggRAM® method in patients diagnosed with NSCLC, prior to any oncological
treatment, in relation to a control group matched by sex, age and presence or absence of
smoking in the previous 6 months. to inclusion Secondary objetives includes laboratorial
test of inflammation, coagulation and subgroup analysis.
