The risk and burden of thromboembolic and hemorrhagic events in patients with malignant gliomas receiving bevacizumab
Purpose Bevacizumab has evolved as an integral treatment option for patients with high-grade gliomas. Little is known about clinical risk factors that predispose patients with high-grade gliomas receiving bevacizumab to VTE or ICH. We sought to characterize the clinical risk factors associated with...
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| Veröffentlicht in: | Journal of neuro-oncology 2024-03, Vol.167 (1), p.181-188 |
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| creator | Dasgupta, Pushan Ou, Alexander Lin, Heather Gregory, Timothy Alfaro-Munoz, Kristin D. Yuan, Ying Afshar-Khargan, Vahid Kamiya-Matsuoka, Carlos Rousseau, Justin F. Majd, Nazanin K. |
| description | Purpose
Bevacizumab has evolved as an integral treatment option for patients with high-grade gliomas. Little is known about clinical risk factors that predispose patients with high-grade gliomas receiving bevacizumab to VTE or ICH. We sought to characterize the clinical risk factors associated with risk of either event.
Methods
In this multi-institutional retrospective study, we first evaluated patients with high-grade gliomas who were treated with bevacizumab at University of Texas MD Anderson Cancer Center from 2015–2021. We compared clinical and treatment-related factors among three cohorts: those who developed VTE, ICH, or neither. We further compared survival outcomes of these patients from the time of bevacizumab initiation. Then to further confirm our results in a non-cancer center hospital setting we evaluated patients from two Ascension Seton Hospitals in Austin, Texas which are affiliated with Dell Medical School at the University of Texas at Austin from 2017–2022.
Results
We found that the presence of cerebral macrobleeding, defined as a magnetic susceptibility of > 1 cm
3
on magnetic resonance imaging, was highly associated with risk of developing ICH after initiation of bevacizumab. Development of ICH was significantly associated with poorer survival outcomes. We did not find a statistically significant effect of VTE on survival after bevacizumab initiation.
Conclusion
In order to stratify the risk for developing ICH before the initiation of bevacizumab, we recommend to assess for the presence of cerebral macrobleeding as it is associated with ICH development. |
| doi_str_mv | 10.1007/s11060-023-04551-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2928585164</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3013915816</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-f7e93d615cf07851437a3dfeb9add2703ddbb12b470183caf4a0ed7d48c1ef0b3</originalsourceid><addsrcrecordid>eNp9kU1v1DAQhi1ERZfCH-CALHHhEjrOJHFyRBUflSpxKRI3y44niUtiL3ayqPx6zG4BiQMHa2zNM69Hehh7IeCNAJCXSQhooIASC6jqWhTdI7YTtcRCosTHbAeikUXdVV_O2dOU7gCgkiiesHNsUZYd4I5ttxPx6NJXrr3lZouWPA8DX6cYFhMon9n1x-ZES4hx0mN-04H8mrjzfK9Xd7x_d-vEFz270Wu_8nF2YdGJR-rJHZwfuaGD7t2PbdHmGTsb9Jzo-UO9YJ_fv7u9-ljcfPpwffX2puixbNZikNShbUTdDyDbWlQoNdqBTKetLSWgtcaI0lQSRIu9HioNZKWt2l7QAAYv2OtT7j6GbxulVS0u9TTP2lPYkiq7sq1zcFNl9NU_6F3Yos_bKQSBnahb0WSqPFF9DClFGtQ-ukXHeyVA_ZKiTlJUlqKOUlSXh14-RG9mIftn5LeFDOAJSLnlR4p___5P7E_YJJmZ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3013915816</pqid></control><display><type>article</type><title>The risk and burden of thromboembolic and hemorrhagic events in patients with malignant gliomas receiving bevacizumab</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Dasgupta, Pushan ; Ou, Alexander ; Lin, Heather ; Gregory, Timothy ; Alfaro-Munoz, Kristin D. ; Yuan, Ying ; Afshar-Khargan, Vahid ; Kamiya-Matsuoka, Carlos ; Rousseau, Justin F. ; Majd, Nazanin K.</creator><creatorcontrib>Dasgupta, Pushan ; Ou, Alexander ; Lin, Heather ; Gregory, Timothy ; Alfaro-Munoz, Kristin D. ; Yuan, Ying ; Afshar-Khargan, Vahid ; Kamiya-Matsuoka, Carlos ; Rousseau, Justin F. ; Majd, Nazanin K.</creatorcontrib><description>Purpose
Bevacizumab has evolved as an integral treatment option for patients with high-grade gliomas. Little is known about clinical risk factors that predispose patients with high-grade gliomas receiving bevacizumab to VTE or ICH. We sought to characterize the clinical risk factors associated with risk of either event.
Methods
In this multi-institutional retrospective study, we first evaluated patients with high-grade gliomas who were treated with bevacizumab at University of Texas MD Anderson Cancer Center from 2015–2021. We compared clinical and treatment-related factors among three cohorts: those who developed VTE, ICH, or neither. We further compared survival outcomes of these patients from the time of bevacizumab initiation. Then to further confirm our results in a non-cancer center hospital setting we evaluated patients from two Ascension Seton Hospitals in Austin, Texas which are affiliated with Dell Medical School at the University of Texas at Austin from 2017–2022.
Results
We found that the presence of cerebral macrobleeding, defined as a magnetic susceptibility of > 1 cm
3
on magnetic resonance imaging, was highly associated with risk of developing ICH after initiation of bevacizumab. Development of ICH was significantly associated with poorer survival outcomes. We did not find a statistically significant effect of VTE on survival after bevacizumab initiation.
Conclusion
In order to stratify the risk for developing ICH before the initiation of bevacizumab, we recommend to assess for the presence of cerebral macrobleeding as it is associated with ICH development.</description><identifier>ISSN: 0167-594X</identifier><identifier>EISSN: 1573-7373</identifier><identifier>DOI: 10.1007/s11060-023-04551-9</identifier><identifier>PMID: 38372903</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Bevacizumab ; Bevacizumab - adverse effects ; Brain cancer ; Brain Neoplasms - pathology ; Cancer therapies ; Case Study ; Chemotherapy ; Clinical trials ; Disease ; Glioma ; Glioma - complications ; Glioma - drug therapy ; Hospitals ; Humans ; Magnetic resonance imaging ; Magnetic susceptibility ; Medicine ; Medicine & Public Health ; Monoclonal antibodies ; Mortality ; Neurology ; Oncology ; Patients ; Retrospective Studies ; Review boards ; Risk Factors ; Statistical analysis ; Survival ; Targeted cancer therapy ; Thromboembolism ; Venous Thromboembolism - chemically induced</subject><ispartof>Journal of neuro-oncology, 2024-03, Vol.167 (1), p.181-188</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-f7e93d615cf07851437a3dfeb9add2703ddbb12b470183caf4a0ed7d48c1ef0b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11060-023-04551-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11060-023-04551-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,777,781,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38372903$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dasgupta, Pushan</creatorcontrib><creatorcontrib>Ou, Alexander</creatorcontrib><creatorcontrib>Lin, Heather</creatorcontrib><creatorcontrib>Gregory, Timothy</creatorcontrib><creatorcontrib>Alfaro-Munoz, Kristin D.</creatorcontrib><creatorcontrib>Yuan, Ying</creatorcontrib><creatorcontrib>Afshar-Khargan, Vahid</creatorcontrib><creatorcontrib>Kamiya-Matsuoka, Carlos</creatorcontrib><creatorcontrib>Rousseau, Justin F.</creatorcontrib><creatorcontrib>Majd, Nazanin K.</creatorcontrib><title>The risk and burden of thromboembolic and hemorrhagic events in patients with malignant gliomas receiving bevacizumab</title><title>Journal of neuro-oncology</title><addtitle>J Neurooncol</addtitle><addtitle>J Neurooncol</addtitle><description>Purpose
Bevacizumab has evolved as an integral treatment option for patients with high-grade gliomas. Little is known about clinical risk factors that predispose patients with high-grade gliomas receiving bevacizumab to VTE or ICH. We sought to characterize the clinical risk factors associated with risk of either event.
Methods
In this multi-institutional retrospective study, we first evaluated patients with high-grade gliomas who were treated with bevacizumab at University of Texas MD Anderson Cancer Center from 2015–2021. We compared clinical and treatment-related factors among three cohorts: those who developed VTE, ICH, or neither. We further compared survival outcomes of these patients from the time of bevacizumab initiation. Then to further confirm our results in a non-cancer center hospital setting we evaluated patients from two Ascension Seton Hospitals in Austin, Texas which are affiliated with Dell Medical School at the University of Texas at Austin from 2017–2022.
Results
We found that the presence of cerebral macrobleeding, defined as a magnetic susceptibility of > 1 cm
3
on magnetic resonance imaging, was highly associated with risk of developing ICH after initiation of bevacizumab. Development of ICH was significantly associated with poorer survival outcomes. We did not find a statistically significant effect of VTE on survival after bevacizumab initiation.
Conclusion
In order to stratify the risk for developing ICH before the initiation of bevacizumab, we recommend to assess for the presence of cerebral macrobleeding as it is associated with ICH development.</description><subject>Bevacizumab</subject><subject>Bevacizumab - adverse effects</subject><subject>Brain cancer</subject><subject>Brain Neoplasms - pathology</subject><subject>Cancer therapies</subject><subject>Case Study</subject><subject>Chemotherapy</subject><subject>Clinical trials</subject><subject>Disease</subject><subject>Glioma</subject><subject>Glioma - complications</subject><subject>Glioma - drug therapy</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic susceptibility</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Monoclonal antibodies</subject><subject>Mortality</subject><subject>Neurology</subject><subject>Oncology</subject><subject>Patients</subject><subject>Retrospective Studies</subject><subject>Review boards</subject><subject>Risk Factors</subject><subject>Statistical analysis</subject><subject>Survival</subject><subject>Targeted cancer therapy</subject><subject>Thromboembolism</subject><subject>Venous Thromboembolism - chemically induced</subject><issn>0167-594X</issn><issn>1573-7373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1v1DAQhi1ERZfCH-CALHHhEjrOJHFyRBUflSpxKRI3y44niUtiL3ayqPx6zG4BiQMHa2zNM69Hehh7IeCNAJCXSQhooIASC6jqWhTdI7YTtcRCosTHbAeikUXdVV_O2dOU7gCgkiiesHNsUZYd4I5ttxPx6NJXrr3lZouWPA8DX6cYFhMon9n1x-ZES4hx0mN-04H8mrjzfK9Xd7x_d-vEFz270Wu_8nF2YdGJR-rJHZwfuaGD7t2PbdHmGTsb9Jzo-UO9YJ_fv7u9-ljcfPpwffX2puixbNZikNShbUTdDyDbWlQoNdqBTKetLSWgtcaI0lQSRIu9HioNZKWt2l7QAAYv2OtT7j6GbxulVS0u9TTP2lPYkiq7sq1zcFNl9NU_6F3Yos_bKQSBnahb0WSqPFF9DClFGtQ-ukXHeyVA_ZKiTlJUlqKOUlSXh14-RG9mIftn5LeFDOAJSLnlR4p___5P7E_YJJmZ</recordid><startdate>20240301</startdate><enddate>20240301</enddate><creator>Dasgupta, Pushan</creator><creator>Ou, Alexander</creator><creator>Lin, Heather</creator><creator>Gregory, Timothy</creator><creator>Alfaro-Munoz, Kristin D.</creator><creator>Yuan, Ying</creator><creator>Afshar-Khargan, Vahid</creator><creator>Kamiya-Matsuoka, Carlos</creator><creator>Rousseau, Justin F.</creator><creator>Majd, Nazanin K.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>20240301</creationdate><title>The risk and burden of thromboembolic and hemorrhagic events in patients with malignant gliomas receiving bevacizumab</title><author>Dasgupta, Pushan ; Ou, Alexander ; Lin, Heather ; Gregory, Timothy ; Alfaro-Munoz, Kristin D. ; Yuan, Ying ; Afshar-Khargan, Vahid ; Kamiya-Matsuoka, Carlos ; Rousseau, Justin F. ; Majd, Nazanin K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-f7e93d615cf07851437a3dfeb9add2703ddbb12b470183caf4a0ed7d48c1ef0b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Bevacizumab</topic><topic>Bevacizumab - adverse effects</topic><topic>Brain cancer</topic><topic>Brain Neoplasms - pathology</topic><topic>Cancer therapies</topic><topic>Case Study</topic><topic>Chemotherapy</topic><topic>Clinical trials</topic><topic>Disease</topic><topic>Glioma</topic><topic>Glioma - complications</topic><topic>Glioma - drug therapy</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic susceptibility</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Monoclonal antibodies</topic><topic>Mortality</topic><topic>Neurology</topic><topic>Oncology</topic><topic>Patients</topic><topic>Retrospective Studies</topic><topic>Review boards</topic><topic>Risk Factors</topic><topic>Statistical analysis</topic><topic>Survival</topic><topic>Targeted cancer therapy</topic><topic>Thromboembolism</topic><topic>Venous Thromboembolism - chemically induced</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dasgupta, Pushan</creatorcontrib><creatorcontrib>Ou, Alexander</creatorcontrib><creatorcontrib>Lin, Heather</creatorcontrib><creatorcontrib>Gregory, Timothy</creatorcontrib><creatorcontrib>Alfaro-Munoz, Kristin D.</creatorcontrib><creatorcontrib>Yuan, Ying</creatorcontrib><creatorcontrib>Afshar-Khargan, Vahid</creatorcontrib><creatorcontrib>Kamiya-Matsuoka, Carlos</creatorcontrib><creatorcontrib>Rousseau, Justin F.</creatorcontrib><creatorcontrib>Majd, Nazanin K.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neuro-oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dasgupta, Pushan</au><au>Ou, Alexander</au><au>Lin, Heather</au><au>Gregory, Timothy</au><au>Alfaro-Munoz, Kristin D.</au><au>Yuan, Ying</au><au>Afshar-Khargan, Vahid</au><au>Kamiya-Matsuoka, Carlos</au><au>Rousseau, Justin F.</au><au>Majd, Nazanin K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The risk and burden of thromboembolic and hemorrhagic events in patients with malignant gliomas receiving bevacizumab</atitle><jtitle>Journal of neuro-oncology</jtitle><stitle>J Neurooncol</stitle><addtitle>J Neurooncol</addtitle><date>2024-03-01</date><risdate>2024</risdate><volume>167</volume><issue>1</issue><spage>181</spage><epage>188</epage><pages>181-188</pages><issn>0167-594X</issn><eissn>1573-7373</eissn><abstract>Purpose
Bevacizumab has evolved as an integral treatment option for patients with high-grade gliomas. Little is known about clinical risk factors that predispose patients with high-grade gliomas receiving bevacizumab to VTE or ICH. We sought to characterize the clinical risk factors associated with risk of either event.
Methods
In this multi-institutional retrospective study, we first evaluated patients with high-grade gliomas who were treated with bevacizumab at University of Texas MD Anderson Cancer Center from 2015–2021. We compared clinical and treatment-related factors among three cohorts: those who developed VTE, ICH, or neither. We further compared survival outcomes of these patients from the time of bevacizumab initiation. Then to further confirm our results in a non-cancer center hospital setting we evaluated patients from two Ascension Seton Hospitals in Austin, Texas which are affiliated with Dell Medical School at the University of Texas at Austin from 2017–2022.
Results
We found that the presence of cerebral macrobleeding, defined as a magnetic susceptibility of > 1 cm
3
on magnetic resonance imaging, was highly associated with risk of developing ICH after initiation of bevacizumab. Development of ICH was significantly associated with poorer survival outcomes. We did not find a statistically significant effect of VTE on survival after bevacizumab initiation.
Conclusion
In order to stratify the risk for developing ICH before the initiation of bevacizumab, we recommend to assess for the presence of cerebral macrobleeding as it is associated with ICH development.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>38372903</pmid><doi>10.1007/s11060-023-04551-9</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0167-594X |
| ispartof | Journal of neuro-oncology, 2024-03, Vol.167 (1), p.181-188 |
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| subjects | Bevacizumab Bevacizumab - adverse effects Brain cancer Brain Neoplasms - pathology Cancer therapies Case Study Chemotherapy Clinical trials Disease Glioma Glioma - complications Glioma - drug therapy Hospitals Humans Magnetic resonance imaging Magnetic susceptibility Medicine Medicine & Public Health Monoclonal antibodies Mortality Neurology Oncology Patients Retrospective Studies Review boards Risk Factors Statistical analysis Survival Targeted cancer therapy Thromboembolism Venous Thromboembolism - chemically induced |
| title | The risk and burden of thromboembolic and hemorrhagic events in patients with malignant gliomas receiving bevacizumab |
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