D-dimers are fragments produced when plasmin cleaves fibrin

• Representing the expression of fibrin formation and fibrinolytic activity of clot breakdown

Several studies considered D-dimer in the prediction of VTE risk in cancer patients and in those scheduled to receive active cancer treatment

The value of D-dimer determination proved effective in lung cancer outpatients, chemo-naïve patients with primary pancreatic adenocarcinoma, advanced gastric cancer patients receiving palliative chemotherapy and in patients with ovarian cancer

D-dimer levels increase with age, age-adjusted cut-off value should be used in patients ≥50 years, by multiplying the patient’s age by 10 µg/mL

A novel biomarker for the diagnosis of VTE

sP-sel derives from the adhesion molecule P-selectin, contained in the granules of platelets and the Weibel–Palade bodies of endothelial cells

Following platelet activation, P-selectin is expressed on the surface membrane and then shed by cleavage

High plasma sP-sel levels may represent an independent VTE risk predictor in cancer patients

sP-sel levels higher than the 75th percentile had a risk of VTE 2.6 times higher than those with lower levels (95% CI, 1.4–4.8)

Tissue factor is the best characterised tumour-derived procoagulant protein. It primarily initiates the extrinsic pathway of the coagulation cascade, resulting in thrombin generation

Malignant tissue involving endothelial and tumour cells constitutively expresses TF

Association of tumour TF expression with risk of VTE has been observed in pancreatic and ovarian cancer