Neutrophil Extracellular Trapping Role in Cancer, Metastases, and Cancer-Related Thrombosis: a Narrative Review of the Current Evidence Base

Curr Oncol Rep. 2021 Aug 3;23(10):118. doi: 10.1007/s11912-021-01103-0.

Abstract

Purpose of review: Neutrophil extracellular trap (NET) formation is a newly discovered, reactive oxygen species-dependent regulated process, whereby neutrophils degranulate and extrude genetic material, after engulfing various infectious or neoplastic antigens, culminating in a measurable serologic footprint. Recent research has highlighted the involvement of NETs in cancer and cancer-related pathologies. We review the role of NET formation in cancer biology, prognosis and potential therapeutic modulators.

Recent findings: Elevated NET levels are associated with cancer metastasis and may be modified by some anaesthetic-analgesic techniques during tumour resection surgery. It promotes tumour cell migration, angiogenesis and hypercoagulability. Although there are potential anti-NET formation therapeutics available, their role has not been formally assessed in cancer patients. Limited available evidence suggests an association between elevated NET expression and cancer metastasis, but its validity as a prognostic indicator for cancer-related outcomes is inconclusive. Further observational and interventional studies are warranted to comprehend the potential prognostic and therapeutic role of NETs in cancer.

Keywords: Cancer; Metastases; NETosis; NETs; Neutrophil extracellular trapping; Neutrophils; Thrombosis; White blood cells.

Publication types

  • Review

MeSH terms

  • Analgesia
  • Biomarkers, Tumor / immunology
  • Biomarkers, Tumor / metabolism
  • Extracellular Traps / drug effects
  • Extracellular Traps / immunology
  • Extracellular Traps / metabolism*
  • Humans
  • Neoplasm Metastasis
  • Neoplasms / immunology
  • Neoplasms / pathology*
  • Neoplasms / therapy
  • Neovascularization, Pathologic
  • Neutrophils / drug effects
  • Neutrophils / immunology
  • Neutrophils / metabolism*
  • Neutrophils / pathology
  • Perioperative Care
  • Thrombosis / immunology
  • Thrombosis / pathology*
  • Thrombosis / therapy

Substances

  • Biomarkers, Tumor