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Tytuł:
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A systematic review on the efficacy and safety of low molecular weight heparin as an anticancer therapeutic in preclinical animal models.
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Autorzy:
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Ripsman D; Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON K1H 8L6, Canada; Faculty of Medicine, University of Ottawa, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada. Electronic address: .
Fergusson DA; Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON K1H 8L6, Canada; Faculty of Medicine, University of Ottawa, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada. Electronic address: .
Montroy J; Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON K1H 8L6, Canada. Electronic address: .
Auer RC; Department of Surgery, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada; Cancer Therapeutics Program, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON K1H 8L6, Canada. Electronic address: .
Huang JW; Faculty of Medicine, University of Ottawa, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada. Electronic address: .
Dobriyal A; Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON K1H 8L6, Canada; Faculty of Medicine, University of Ottawa, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada. Electronic address: .
Wesch N; Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON K1H 8L6, Canada.
Carrier M; Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON K1H 8L6, Canada; Faculty of Medicine, University of Ottawa, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada. Electronic address: .
Lalu MM; Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON K1H 8L6, Canada; Department of Anesthesiology and Pain Medicine, The Ottawa Hospital, Room B307, 1053 Carling Avenue, Mail Stop 249, Ottawa, ON K1Y 4E9, Canada; Regenerative Medicine Program, Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON K1H 8L6, Canada. Electronic address: .
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Źródło:
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Thrombosis research [Thromb Res] 2020 Nov; Vol. 195, pp. 103-113. Date of Electronic Publication: 2020 Jul 08.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't; Systematic Review
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Język:
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English
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Imprint Name(s):
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Original Publication: Elmsford, N. Y., Pergamon Press.
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MeSH Terms:
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Heparin, Low-Molecular-Weight*/therapeutic use
Neoplasms*/drug therapy
Animals ; Anticoagulants ; Heparin ; Models, Animal
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Contributed Indexing:
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Keywords: Animal models; Heparin; Meta-analysis; Neoplasms; Systematic review; Thrombosis
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Substance Nomenclature:
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0 (Anticoagulants)
0 (Heparin, Low-Molecular-Weight)
9005-49-6 (Heparin)
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Entry Date(s):
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Date Created: 20200720 Date Completed: 20210617 Latest Revision: 20210617
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Update Code:
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20240105
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DOI:
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10.1016/j.thromres.2020.07.008
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PMID:
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32683148
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Objective: The therapeutic effects of low molecular weight heparins (LMWH) may extend past thrombosis prevention, with preclinical evidence demonstrating anti-metastatic properties. Clinical evidence on the topic, however, remains controversial. A systematic review of preclinical evidence may help elucidate reasons for this contradictory evidence. The objective of our systematic review is to assess the anti-metastatic properties of LMWHs in solid tumour animal models.
Methods: MEDLINE, Embase, Web of Science and PubMed were searched from inception to May 12th, 2020. All articles were screened independently and in duplicate. Studies that compared LMWH to a placebo or no treatment arm in solid tumour animal models were included. The primary outcome was the burden of metastasis. Secondary outcomes included primary tumour growth and mortality. The risk of bias was assessed in duplicate using a modified Cochrane Risk of Bias tool.
Results: Forty-two studies were included in the review. Administration of a LMWH was associated with a significant decrease in the burden of metastasis (SMD -2.18; 95% CI -2.66 to -1.70). Additionally, the administration of a LMWH was also associated with a significant reduction in primary tumour growth (SMD -1.95; 95% CI -2.56 to -1.34) and risk of death (RR 0.39; 95% CI 0.16-0.97). All included studies were deemed to be at an unclear risk of bias for at least one methodological criterion.
Conclusions: Our results demonstrate that LMWH can effectively reduce metastatic burden and reduce tumour growth in preclinical animal models of solid tumour malignancies. Reasons for the contradiction with clinical evidence require further exploration.
(Copyright © 2020 Elsevier Ltd. All rights reserved.)
