[Anti-angiogenic therapies and hemorrhagic risk].
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.
Ayllon
J
J
Service d'Oncologie médicale, Hôpital Européen Georges-Pompidou, rue Leblanc, Paris cedex 15, France.
Pignot
G
G
D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery; D011183:Postoperative Complications / Q000139:chemically induced*; D012307:Risk Factors
D020533:Angiogenesis Inhibitors