Cancer and Metastasis Reviews

, Volume 36, Issue 2, pp 199–213 | Cite as

Platelet “first responders” in wound response, cancer, and metastasis

  • David G. MenterEmail author
  • Scott Kopetz
  • Ernest Hawk
  • Anil K. Sood
  • Jonathan M. Loree
  • Paolo Gresele
  • Kenneth V. Honn


Platelets serve as “first responders” during normal wounding and homeostasis. Arising from bone marrow stem cell lineage megakaryocytes, anucleate platelets can influence inflammation and immune regulation. Biophysically, platelets are optimized due to size and discoid morphology to distribute near vessel walls, monitor vascular integrity, and initiate quick responses to vascular lesions. Adhesion receptors linked to a highly reactive filopodia-generating cytoskeleton maximizes their vascular surface contact allowing rapid response capabilities. Functionally, platelets normally initiate rapid clotting, vasoconstriction, inflammation, and wound biology that leads to sterilization, tissue repair, and resolution. Platelets also are among the first to sense, phagocytize, decorate, or react to pathogens in the circulation. These platelet first responder properties are commandeered during chronic inflammation, cancer progression, and metastasis. Leaky or inflammatory reaction blood vessel genesis during carcinogenesis provides opportunities for platelet invasion into tumors. Cancer is thought of as a non-healing or chronic wound that can be actively aided by platelet mitogenic properties to stimulate tumor growth. This growth ultimately outstrips circulatory support leads to angiogenesis and intravasation of tumor cells into the blood stream. Circulating tumor cells reengage additional platelets, which facilitates tumor cell adhesion, arrest and extravasation, and metastasis. This process, along with the hypercoagulable states associated with malignancy, is amplified by IL6 production in tumors that stimulate liver thrombopoietin production and elevates circulating platelet numbers by thrombopoiesis in the bone marrow. These complex interactions and the “first responder” role of platelets during diverse physiologic stresses provide a useful therapeutic target that deserves further exploration.


Platelet TCIPA Metastasis Thrombosis Extravasation CTC 



Grant and other support

Boone Pickens Distinguished Chair for Early Prevention of Cancer, Duncan Family Institute, Colorectal Cancer Moon Shot, P30CA016672-41, 1R01CA187238-01, 5R01CA172670-03, and 1R01CA184843-01A1, CA177909, and the American Cancer Society Research Professor Award.

Compliance with ethical standards

Conflict of interests

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • David G. Menter
    • 1
    Email author
  • Scott Kopetz
    • 1
  • Ernest Hawk
    • 2
  • Anil K. Sood
    • 3
    • 4
    • 5
  • Jonathan M. Loree
    • 1
  • Paolo Gresele
    • 6
  • Kenneth V. Honn
    • 7
    • 8
    • 9
  1. 1.Department of Gastrointestinal Medical OncologyM. D. Anderson Cancer CenterHoustonUSA
  2. 2.Office of the Vice President Cancer Prevention & Population ScienceM. D. Anderson Cancer CenterHoustonUSA
  3. 3.Gynocologic Oncology & Reproductive Medicine M. D. Anderson Cancer CenterHoustonUSA
  4. 4.Department of Cancer BiologyM. D. Anderson Cancer CenterHoustonUSA
  5. 5.Center for RNA Interference and Non-Coding RNA The University of Texas MD Anderson Cancer CenterHoustonUSA
  6. 6.Department of Medicine, Section of Internal and Cardiovascular MedicineUniversity of PerugiaPerugiaItaly
  7. 7.Bioactive Lipids Research Program, Department of PathologyWayne State UniversityDetroitUSA
  8. 8.Department of PathologyWayne State UniversityDetroitUSA
  9. 9.Cancer Biology DivisionWayne State University School of MedicineDetroitUSA

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