Microfluidic Platforms for Modeling Cancer-Associated Thrombosis: Current Status and Future Directions.

Cancer-associated thrombosis (CAT) is the second leading cause of death among cancer patients. Its pathogenesis is multifactorial and involves dynamic interactions among tumor cells, platelets, coagulation factors, endothelial cells, immune cells, and blood flow. Traditional in vitro 2-dimensional models fail to accurately mimic the dynamic microenvironment of CAT in humans. Although animal models can mimic complex pathological conditions, significant differences in the composition and regulation of the coagulation system between animals and humans limit their ability to accurately model CAT in humans. In this review, we briefly outline the mechanisms involved in CAT to provide the biological rationale for the design of emerging microfluidic platforms. We then discuss how these platforms have advanced CAT research. The ability of microfluidic platforms to precisely control perfusion, cellular composition, and flow rate enables researchers to accurately simulate the human cancer-vascular microenvironment in vitro and investigate cancer-specific mechanisms of thrombosis. We further discuss the challenges that need to be addressed for microfluidic models to support basic and clinical research.