The investigators showed in the experimental model that TF expressed by cancer cells was involved in thrombosis associated with a cancer and in the growth of the tumor in vivo. Beside its functions in coagulation, TF was also described following phosphorylation and binding of its cytoplasmic tail to filamin, to induce transcriptional activation of different growth factors, including VEGF. This intracellular pathway may also participate in the growth of the tumor, but also in angiogenesis. Furthermore, TF expression was also reported to influence motility, survival and proliferation of cancer cells via the activation of PAR-1 and PAR-2, although in this study proliferation of Panc02 cells were not affected by inhibition of TF expression. Cancer cells may directly activate platelets by secreting ADP, Thromboxane A2 and MMP-2 (Matrix Metallo Proteinase 2) and express at their surface ligands to platelets, such as PSGL-1. In bloodstream, this leads to an aggregation of platelets around cancer cells described to protect them from destruction by the immune system, blood shear stress and to facilitate cancer cells interactions with the endothelium. However, the direct involvement of these platelet agonists was not demonstrated in vivo. When mice were treated with LMWH, a decrease in tumor development was observed similar to the ones obtained when pathological TF was shut down. Also, treatment by Clopidogrel did not significantly affect the growth of the tumor in the group of Panc02 miRNA TF mice or in the group of Panc02 mice treated by LMWH. This strongly suggests that activation of platelets is involved in the growth of the tumor, but also that the main activator of platelet is TF expressed by cancer cells and nor ADP nor Thromboxane A2. These secondary agonists may be involved when secreted as a consequence of platelet activation generated by thrombin through a TF dependent pathway. Last, they may play an important role not directly in the growth of the tumor, but rather in the formation of metastasis when cancer cells have to be present in the bloodstream.