What is it about?

The characterization of the risk factors and stroke mechanisms is primordial since bevacizumab is currently used in the treatment of glioblastoma and VEGF receptor tyrosine-kinase inhibitors are actually in clinical trials for malignant gliomas. The prevention and optimal treatment of strokes depend on a precise description of the pathophysiological mechanisms involved. This retrospective study is performed with the collaboration of Roche to evaluate in detail risk factors and stroke mechanisms in the population of patients diagnosed with a glioblastoma who presented an ischemic cerebral stroke during the course of a bevacizumab treatment. The impact of the stroke on the overall survival and the location of the infarct in relation to the tumor emplacement will also be evaluated.

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Why is it important?

Bevacizumab is an anti-vascular endothelial growth factor approved in the treatment of recurrent glioblastoma. It prolongs progression-free survival, improves radiologic response and contributes to reduce the dose of dexamethasone required to control peritumoral edema. Arterial and venous thromboembolic events represent significant toxicities related to the use of angiogenesis inhibitors. Various mechanisms could be implicated in bevacizumab-related strokes, as cardio-embolic, lacunar stroke related to hypertension, deep venous thrombosis passing through a patent foramen ovale, pro-coagulant effect of the underlying glioblastoma and radiation-induced damages on peritumoral vessels.

Perspectives

The prevention and optimal treatment of strokes depend on a precise description of the pathophysiological mechanisms involved. This retrospective study is performed with the collaboration of Roche to evaluate in detail risk factors and stroke mechanisms in the population of patients diagnosed with a glioblastoma who presented an ischemic cerebral stroke during the course of a bevacizumab treatment. The impact of the stroke on the overall survival and the location of the infarct in relation to the tumour emplacement will also be evaluated. Category: Complication of Therapy and Neurotoxicity

Dr Catherine Maurice
University of Toronto

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This page is a summary of: CN-14 * RETROSPECTIVE ANALYSIS OF ISCHEMIC CEREBRAL STROKES IN PATIENTS DIAGNOSED WITH A GLIOBLASTOMA DURING THE COURSE OF A BEVACIZUMAB TREATMENT, Neuro-Oncology, November 2014, Oxford University Press (OUP), DOI: 10.1093/neuonc/nou243.14.
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