Ischemic Stroke in Cancer: Mechanisms, Biomarkers, and Implications for Treatment.

Costamagna, Gianluca; Navi, Babak B; Beyeler, Morin; Hottinger, Andreas F; Alberio, Lorenzo; Michel, Patrik (2024). Ischemic Stroke in Cancer: Mechanisms, Biomarkers, and Implications for Treatment. Seminars in thrombosis and hemostasis, 50(3), pp. 342-359. Thieme 10.1055/s-0043-1771270

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Ischemic stroke is an important cause of morbidity and mortality in cancer patients. The underlying mechanisms linking cancer and stroke are not completely understood. Long-standing and more recent evidence suggests that cancer-associated prothrombotic states, along with treatment-related vascular toxicity, such as with chemotherapy and immunotherapy, contribute to an increased risk of ischemic stroke in cancer patients. Novel biomarkers, including coagulation, platelet and endothelial markers, cell-free DNA, and extracellular vesicles are being investigated for their potential to improve risk stratification and patient selection for clinical trials and to help guide personalized antithrombotic strategies. Treatment of cancer-related stroke poses unique challenges, including the need to balance the risk of recurrent stroke and other thromboembolic events with that of bleeding associated with antithrombotic therapy. In addition, how and when to restart cancer treatment after stroke remains unclear. In this review, we summarize current knowledge on the mechanisms underlying ischemic stroke in cancer, propose an etiological classification system unique to cancer-related stroke to help guide patient characterization, provide an overview of promising biomarkers and their clinical utility, and discuss the current state of evidence-based management strategies for cancer-related stroke. Ultimately, a personalized approach to stroke prevention and treatment is required in cancer patients, considering both the underlying cancer biology and the individual patient's risk profile.

Item Type:	Journal Article (Review Article)
Division/Institute:	04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
UniBE Contributor:	Beyeler, Morin
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1098-9064
Publisher:	Thieme
Language:	English
Submitter:	Pubmed Import
Date Deposited:	03 Aug 2023 11:10
Last Modified:	10 Mar 2024 00:12
Publisher DOI:	10.1055/s-0043-1771270
PubMed ID:	37506734
URI:	https://boris.unibe.ch/id/eprint/185122