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Low molecular weight heparin and direct oral anticoagulants influence tumour formation, growth, invasion and vascularisation by separate mechanisms

Featherby, Sophie; Xiao, Yu Pei; Ettelaie, Camille; Nikitenko, Leonid L.; Greenman, John; Maraveyas, Anthony


Sophie Featherby

Yu Pei Xiao

Camille Ettelaie

Anthony Maraveyas


The bidirectional association between coagulation and cancer has been established. However, anticoagulant therapies have been reported to have beneficial outcomes by influencing the vascularisation of the tumours. In this study the influence of a set of anticoagulants on tumour formation, invasion and vascularisation was examined. WM-266-4 melanoma and AsPC-1 pancreatic cancer cell lines were treated with LMWH (Tinzaparin and Dalteparin), and DOAC (Apixaban and Rivaroxaban) and the rate of tumour formation, growth and invasion were measured in vitro. In addition, the influence of these anticoagulants on vascularisation was examined using the chorioallantoic membrane assay (CAM) model and compared to the outcome of treatment with Bevacizumab. Using this model the influence of pharmacological concentrations of the anticoagulant on the growth, invasion and vascularisation of tumours derived from WM-266-4 and AsPC-1 cells was also measured in vivo. Tinzaparin and Daltepain reduced tumour formation and invasion by the cell lines in vitro, but with dissimilar potencies. In addition, treatment of CAM with LMWH reduced the local vascular density beyond that achievable with Bevacizumab, particularly suppressing the formation of larger-diameter blood vessels. In contrast, treatment with DOAC was largely ineffective. Treatment of CAM-implanted tumours with LMWH also reduced tumour vascularisation, while treatment of tumours with Apixaban reduced tumour growth in vivo. In conclusion, LMWH and DOAC appear to have anti-cancer properties that are exerted through different mechanisms.


Featherby, S., Xiao, Y. P., Ettelaie, C., Nikitenko, L. L., Greenman, J., & Maraveyas, A. (2019). Low molecular weight heparin and direct oral anticoagulants influence tumour formation, growth, invasion and vascularisation by separate mechanisms. Scientific reports, 9(1), Article 6272.

Journal Article Type Article
Acceptance Date Apr 5, 2019
Online Publication Date Apr 18, 2019
Publication Date 2019-12
Deposit Date May 15, 2019
Publicly Available Date Oct 27, 2022
Journal Scientific Reports
Print ISSN 2045-2322
Electronic ISSN 2045-2322
Publisher Nature Publishing Group
Peer Reviewed Peer Reviewed
Volume 9
Issue 1
Article Number 6272
Keywords Cell invasion; Drug development; Tumour angiogenesis
Public URL
Publisher URL
Additional Information Received: 16 November 2018; Accepted: 5 April 2019; First Online: 18 April 2019; : The authors declare no competing interests.


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