SUDA Pharmaceuticals Ltd. provides the following update on its development of anagrelide, an anti-thrombotic agent, that has shown promise as a novel anti-cancer agent. There have been a number of articles recently on the need for chemo-preventative strategies in cancer. With more than 14 million cases of cancer reported per year and estimated to reach nearly 22 million globally by 2030 (Bray et al., 2015) the cancer burden and deaths from cancer are increasing worldwide. The escalating costs of diagnosing and managing cancer are clearly not sustainable and it is well recognised that treatment of cancer is becoming increasingly unaffordable as the incidence increases for a variety of reasons (aging population, environmental, chemical exposures etc). It is becoming more accepted that the only financially viable strategy would seem to be cancer prevention. A recent paper by Serrano etal. (Molecular Oncology; V13 Issue 3. January 2019) drew an analogy between the potential of cancer chemo-prevention strategies and those used for risk reduction incardiovascular disease. Serrano explains that therapeutic prevention is standard practice in cardiovascular disease (CVD) where use of antihypertensives, statins and antiplatelet drugs have contributed to a dramatic decline in mortality due to CVD over the past ~40 years. Serrano attributes the success in CVD prevention to the relatively straight forward relationship between the disease and related biomarkers. For example, high blood pressure or high lowdensity cholesterol (LDL) can be considered disease surrogate biomarkers. There is now significant evidence to suggest that platelet count may afford a useful surrogate biomarker for cancer which could then point to the need for prophylactic intervention. Several recent reports have suggested that patients with high platelet counts should be tested for cancer and that GP's should be urged to think cancer when diagnosing thrombocytosis (Bailey et al 2017). Much of this thinking emanates from the now appreciated role of platelets in providing the angiogenic growth factors for the initial development of the primary tumour development and the part played by cancer cells in triggering the production of more platelets so propagating the process and establishing a potentially a fatal loop. The use of platelets as surrogate biomarkers in cancer risk /diagnosis then poses the question of what chemo-prevention strategies could be utilised company have previously explained that anagrelide could be complementary to many cancer treatments by reducing platelet numbers so minimising the proliferative and protective effect that platelets exhibit on metastatic cells, thereby potentially offering a novel and valuable first-in-class treatment option for cancer. The company have, however, not previously highlighted that it is this basic activity that could also render anagrelide suitable as a chemo-preventative product. SUDA's anagrelide patent already addresses the potential prophylactic use of anagrelide as a chemo-preventative agent. Identifying at risk patients and then providing prophylactic platelet lowering therapy with an anagrelide oral spray, may lead to an improved outcome for those patients. The company believe that the potential value of prophylactic use of anagrelide in at risk patients could be immense if the statins and CVD are anything to go by.