PhD defence Patricia Gomez Rosas

Keywords: Hypercoagulability, Hemostatic biomarkers, Cancer-associated thrombosis

"The Role of Biomarkers of Hypercoagulability: Evaluating Thrombosis Risk and Outcomes in Cancer Patients"

This thesis examines the role of hemostatic biomarkers in predicting clinical outcomes among cancer patients enrolled in the Italian, multicenter, observational HYPERCAN (HYPERcoagulation in CANcer) study. By investigating the relationship between hypercoagulability and malignancy, the research identifies how markers such as D-dimer, fibrinogen, and thrombin generation parameters predict cancer-associated thrombosis (CAT), disease progression, and mortality. These findings led to the development of specialized risk assessment models, notably the lung-HYPERCAN score, which outperforms existing standards in predicting venous thromboembolism in patients with non-small cell lung cancer (NSCLC). Additionally, this thesis shows that high fibrinogen and Ki-67 levels effectively stratify risk in metastatic breast cancer, whereas high-sensitivity CRP and D-dimer serve as early indicators of progression in NSCLC. Furthermore, the validation of thrombin generation as a marker of cancer recurrence underscores the overall prognostic utility of plasma biomarkers in enhancing risk stratification and clinical management for breast cancer patients. Finally, the work addresses the prevalence and therapeutic challenges of thrombocytopenia in oncology, emphasizing management strategies such as platelet transfusions and calibrated anticoagulation therapy to balance bleeding and thrombosis risks for each patient's profile.

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