Circulating tumor cells and circulating tumor microemboli: role in venous thromboembolism in oncologic patients

Venous thromboembolism (VTE) is one of the most frequent and serious complications in cancer patients, contributing significantly to morbidity, mortality, and increased healthcare burden. Circulating tumor cells (CTCs) and circulating tumor microemboli (CTMs), components of the liquid biopsy, have emerged not only as biomarkers of disease progression and therapeutic resistance but also as potential contributors to prothrombotic states in oncologic patients. In this review, we explore the biological and clinical relationships between CTCs/CTMs and the development of VTE, highlighting mechanistic insights involving tumor-platelet interactions, immune evasion, and endothelial dysfunction. We also discuss recent findings on the prognostic value of CTCs and CTMs for thromboembolic risk stratification, as well as technological advances in their detection. Understanding the role of these circulating tumor-derived elements may open new perspectives for personalized prevention and management of thromboembolic events in cancer patients.