Initiating or Resuming Cancer Treatment After Ischemic Stroke and Clinical Outcomes

Area of Science:

• Neurology
• Oncology
• Public Health

Background:

• Patients with acute ischemic stroke (AIS) and active cancer (AC) face high risks of mortality and stroke recurrence.
• The impact of initiating or resuming active cancer treatment (ACT) after AIS on these outcomes is not well understood.

Purpose of the Study:

• To determine the proportion of AIS patients with AC who initiate or resume ACT within 3 months post-stroke.
• To evaluate the clinical characteristics and outcomes associated with initiating or resuming ACT.

Main Methods:

• Retrospective analysis of 260 eligible patients with AC from the Acute STroke Registry and Analysis of Lausanne (2003-2021).
• Comparison of outcomes (mortality, functional status via mRS, cerebrovascular recurrence) between patients who did and did not resume ACT within 3 months.
• Multivariable regression and propensity score matching (PSM) were used for analysis.

Main Results:

• 45% of eligible patients initiated or resumed ACT post-AIS, with chemotherapy being the most common treatment.
• Lower stroke severity was associated with resuming ACT.
• Resuming ACT was linked to significantly reduced mortality at 3 and 12 months (pre-PSM).
• No significant differences were observed in functional outcomes (mRS) or cerebrovascular recurrence risk between groups.

Conclusions:

• Almost half of AIS patients with AC resume cancer treatment within 3 months.
• Initiating or resuming ACT is associated with reduced medium-term mortality after AIS.
• Cancer treatment resumption did not impact functional recovery or stroke recurrence risk.