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Introduction
Heparin was first discovered in 1916 by Jay McLean, a medical student working under William Howell at Johns Hopkins School of Medicine, and although it was not initially utilized clinically, it gained recognition two decades later when Charles Best and Gordon Murray demonstrated its effectiveness in treating venous thrombosis [1]. The structural intricacies of heparin were only elucidated in the 1980s when a specific antithrombin-binding pentasaccharide segment was identified. Currently, heparin serves not only as an anticoagulant but also finds applications in respiratory diseases, inflammation, and even antimicrobial treatment [2, 3–4]. There are two primary forms of heparin used clinically: Low Molecular Weight Heparin (LMWH) and Unfractionated Heparin (UFH). LMWH has gradually become the preferred choice due to its comparable efficacy and reduced bleeding risks compared to UFH [5]. Heparin exerts its anticoagulant effects by inactivating thrombin and activated factor X through an antithrombin (AT)-dependent pathway, with its smaller fragments specifically inhibiting Factor Xa and thereby contributing to its anticoagulant properties [6]. In recent years, growing evidence has indicated heparin’s potential anticancer effects, which extend beyond its anticoagulant properties. Studies have suggested that heparin can inhibit cancer metastasis, tumor growth, and angiogenesis [7, 8]. This review aims to synthesize current data on heparin’s anticancer mechanisms and explore its potential role in oncology, with an emphasis on its derivatives and their clinical implications.
Methodology
To conduct a comprehensive literature review, databases such as PubMed, Scopus, Web of Science, and Google Scholar were utilized. The search strategy integrated a combination of keywords and Medical Subject Headings (MeSH) terms. Keywords included Heparin, Anticancer, Oncology, Low Molecular Weight Heparin, Unfractionated Heparin, Cancer Therapy, Thrombosis, and Anticoagulation. Corresponding MeSH Terms were “Heparin”, “Neoplasms”, “Anticoagulants”, “Low Molecular Weight Heparin”, and “Thrombosis”. Inclusion criteria were set to encompass studies focusing on the use of heparin or its derivatives for cancer treatment, articles providing insights into the mechanisms of action of heparin in oncology, clinical trials, in-vivo, and in-vitro studies, and studies published in peer-reviewed journals. Articles needed to be available in English and published in the last 15 years to ensure contemporary relevance. Exclusion criteria were established to filter out studies not specifically addressing heparin or its derivatives in the context of cancer therapy, papers focusing solely on the traditional anticoagulant...