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Updated: Jun 12, 2026
Intrastriatal Injection of Autologous Blood or Clostridial Collagenase as Murine Models of Intracerebral Hemorrhage
Published on: July 3, 2014
[Anti-angiogenic therapies and hemorrhagic risk]
1Service d'Oncologie médicale, Hôpital Européen Georges-Pompidou, rue Leblanc, Paris cedex 15, France.
Abstract:
Anti-angiogenic therapies induce an ischemic necrosis of tumoral tissue, which exposes to a risk of hemorrhagic complications. The frequency and the intensity of the symptoms may differ according to molecules and according to studies. The risk seems to be maximal with tyrosin kinase inhibitors, particularly with sunitinib, with 26% of hemorrhagic complications. In most cases, events are grade 1 or 2, severe adverse effects (grade 3 or 4) appear rarely. Intra-cerebral bleeding remains rare and seems to be observed essentially in case of cerebral metastases. The hemorrhagic risk seems to be correlated with arterial high blood pressure and concomitant thrombopenia. The management of hemorrhagic risk is essentially based on precautionary measures. For any surgical procedure, it is advised to interrupt the treatment at least 4 weeks before and 4 weeks later, in order to avoid parietal complications.
Insights
Anti-angiogenic therapies can cause tumor bleeding, especially with tyrosine kinase inhibitors like sunitinib. While severe complications are rare, managing hemorrhagic risk involves precautionary measures, including treatment interruption before surgery.
Area of Science:
- Oncology
- Pharmacology
Context:
- Anti-angiogenic therapies are used to treat cancer by inhibiting tumor blood vessel formation.
- Tumor necrosis induced by these therapies can lead to hemorrhagic complications.
- The risk and severity of bleeding vary among different anti-angiogenic agents.
Purpose:
- To analyze the incidence and characteristics of hemorrhagic complications associated with anti-angiogenic therapies.
- To identify specific agents and patient factors contributing to bleeding risk.
- To review management strategies for preventing and handling hemorrhagic events.
Summary:
- Tyrosine kinase inhibitors, particularly sunitinib, show a maximal risk of hemorrhagic complications (26%).
- Most bleeding events are low-grade (1-2), with severe (3-4) complications being rare.
- Intracerebral bleeding is uncommon, primarily observed in patients with brain metastases.
- Hemorrhagic risk is associated with hypertension and thrombocytopenia.
- Precautionary measures, including a 4-week pre- and post-operative treatment interruption, are recommended for surgical procedures.
Impact:
- Highlights the need for careful patient monitoring during anti-angiogenic therapy.
- Informs clinical decision-making regarding the use of specific agents and surgical interventions.
- Provides guidance on managing bleeding risks in cancer patients undergoing anti-angiogenic treatment.
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