RESUMEN
Oral squamous cell carcinoma (OSCC) is the most common head and neck cancer. With anticoagulant usage on the rise, it is important to elucidate their potential effects on tumour biology and interactions with chemotherapeutics. The aim of the present study was to investigate the effects of anticoagulants on OSCC cell lines and their interactions with the drug 5-fluorouracil (5-FU). Cell proliferation was assessed using an MTS in vitro assay in two human OSCC cell lines (H357/H400) and in normal oral keratinocytes (OKF6) treated with the 5-FU (0.2/1/5/10 µg/mL), conventional anticoagulants warfarin (1/5/10/20 µM) and heparin (5/20/80 U), as well as four new oral anticoagulants, dabigatran (5/10/20 µM), rivaroxaban (5/10/20 µM), apixaban (0.1/1/5 µg/mL), and edoxaban (5/10/20 µM). Cell migration was assessed at 3 h intervals up to18 h using a wound healing assay. Our results clearly demonstrate, for the first time, that commonly prescribed anticoagulants exert in vitro antiproliferative effects on OSCC cells. Furthermore, treatment with some anticoagulants reduced the migration of OSCC cell lines. Nevertheless, most of the anticoagulants tested reduced the effectiveness of the chemotherapeutic agent tested, 5-FU, highlighting potential flaws in the current pharmacological management of these patients. Our findings showed the need for the immediate translation of this research to preclinical animal models.
RESUMEN
Tumour progression allows for aberrant angiogenesis. Consequently, cancer-associated thrombosis is a prevalent complication that is coupled with poor prognosis. Anticoagulants have therefore been prescribed with chemotherapeutic agents to target potential thrombo-embolic risk. A systematic review was carried out to summarise existing evidence on the interactions between anticoagulants and oral cancer. This treatment paradigm has demonstrated beneficial results in some oncology patients, thus associating anticoagulants with anticancer effects. Increasing prevalence of oral cancer presents a need to source alternative therapeutic means to prevent disease progression, and thus the use of anticoagulants in these patients may provide an avenue for this to occur. The paucity of evidence regarding the interactions between oral squamous cell carcinoma and anticoagulants emphasises the urgency with which further research should be conducted.
