Related Experiment Video
Updated: May 17, 2026
Preparation Of Neovascular Tissues from Human Glioma Tissues for Quantitative Proteomics Analysis of Tumor Angiogenesis
Published on: March 20, 2026
A comprehensive analysis of vascular complications in 3,889 glioma patients from the German Glioma Network
C Seidel1, B Hentschel, M Simon
1Department of Neurooncology, Neurology Clinic and National Centre for Tumour Disease, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Insights
Vascular events like ischemic strokes and intracranial hemorrhages (ICH) are common in glioma patients. Bevacizumab (BEV) treatment increased ischemic stroke risk but not ICH or deep venous thromboembolism (DVT).
Area of Science:
- Neuro-oncology
- Vascular Neurology
- Oncologic Therapeutics
Background:
- Vascular events, including ischemic strokes, intracranial hemorrhages (ICH), and deep venous thromboembolism (DVT), are significant clinical concerns for glioma patients.
- Anti-angiogenic therapy, particularly with bevacizumab (BEV), is used in glioma treatment, necessitating an understanding of its association with vascular events.
Purpose of the Study:
- To investigate the frequency, contributing factors, and outcomes of vascular events in glioma patients undergoing anti-angiogenic therapy with bevacizumab (BEV).
- To compare the incidence of vascular events between BEV-treated and non-BEV-treated glioma patients.
- To analyze the timing and outcomes of vascular events, particularly in relation to surgery.
Main Methods:
- A multicentre, non-interventional observational study involving 3,889 glioma patients from the German Glioma Network.
- Data collection focused on the occurrence, characteristics, and outcomes of ischemic strokes, ICH, and DVT.
- Comparison of event rates between patients treated with BEV and those not treated with BEV, and analysis of postoperative versus spontaneous events.
Main Results:
- Overall rates: 1.8% ischemic strokes, 3.2% ICH, and 5.0% DVT (in 2,855 patients).
- DVT and ICH rates increased with glioma World Health Organization (WHO) grade.
- In 81 BEV-treated patients, rates were 6.2% ischemic strokes, 1.2% ICH, and 7.4% DVT. Ischemic stroke rate was significantly higher with BEV (p < 0.001), but DVT and ICH rates did not differ.
- Postoperative occurrence was common for ICH (67%), ischemic strokes (61%), and DVT (18%).
- Postoperative ICH had a worse outcome than spontaneous ICH (p = 0.008).
Conclusions:
- Bevacizumab (BEV) treatment is associated with a significantly higher rate of ischemic strokes in glioma patients.
- The incidence of DVT and ICH did not significantly differ between BEV-treated and non-BEV-treated patients.
- A substantial proportion of vascular events occurred postoperatively, with postoperative ICH having poorer outcomes.
- The study highlights the need to monitor therapy-associated intracerebral diffusion restrictions in ongoing clinical trials.
Abstract:
Ischemic strokes, intracranial hemorrhages (ICH) and deep venous thromboembolism (DVT) are clinically important events in patients with gliomas. In this multicentre, noninterventional observational study, current data pertaining to frequency, contributing factors and outcomes of vascular events during times of anti-angiogenic therapy with the antibody against vascular endothelial growth factor, bevacizumab (BEV) was collected from the German Glioma Network. Among 3,889 glioma patients, 70 ischemic strokes (1.8 %) and 123 ICH (3.2 %) were recorded. 143 DVT (5.0 %) were recorded in 2,855 patients. Rates of DVT and ICH, but not of ischemic strokes, increased with the World Health Organization (WHO) grade of glioma. In 81 BEV-treated patients, five ischemic strokes (6.2 %), one ICH (1.2 %) and six DVT (7.4 %) were documented. Compared to patients that were not treated with BEV, ischemic stroke rate was significantly higher during treatment with BEV (p < 0.001). The rates of DVT (p = 0.123) or ICH (p = 0.571) in BEV-treated patients did not differ. On cerebral magnetic resonance imaging (MRI), BEV-related ischemic strokes appeared as diffusion-restricted sites next to contrast-enhancing tumor. 67 % of ICH, 61 % of ischemic strokes and 18 % of DVT occurred postoperatively (within 30 days after tumor resection). Outcome after postoperative ICH was significantly worse than after spontaneous ICH (p = 0.008). Ischemic stroke outcomes did not differ between postoperative and spontaneous occurrence (p = 0.401). Rate of pulmonary embolism did not differ significantly between postoperative and spontaneous DVT (p = 0.133). Relatively low rates of ICH and DVT might be partially due to a high proportion of low-grade gliomas in this patient cohort. The finding of a relevant number of symptomatic, therapy-associated intracerebral diffusion restrictions should be controlled in ongoing phase III studies.
