Editors' Note: Clinical Outcome After Endovascular Treatment in Patients With Active Cancer and Ischemic Stroke: A MR CLEAN Registry Substudy

Abstract

In “Clinical Outcome After Endovascular Treatment in Patients With Active Cancer and Ischemic Stroke: A MR CLEAN Registry Substudy,” Verschoof et al. reported that despite similar technical success, patients with active cancer who underwent endovascular thrombectomy (EVT) experienced worse functional outcomes and a higher risk of mortality 90 days poststroke than patients without active cancer. Moores and Ganesh noted that these findings are consistent with results from the ESCAPE and ESCAPE-NA1 trials and it remains unclear how to identify patients who meet existing selection criteria for EVT but have no potential for benefit from EVT because they experience active cancer. They emphasized the importance of shared decision-making in these challenging situations, particularly when workup for acute stroke uncovers a new diagnosis of cancer. Verschoof et al. responded that the ESCAPE and ESCAPE-NA1 trials included 4 patients with cancer but did not comment on whether it was active. Because of the difficulty forming conclusions about the use of EVT in patients with active cancer through observational studies, they recommended the need for a controlled trial to study EVT in patients with active cancer. In “Clinical Outcome After Endovascular Treatment in Patients With Active Cancer and Ischemic Stroke: A MR CLEAN Registry Substudy,” Verschoof et al. reported that despite similar technical success, patients with active cancer who underwent endovascular thrombectomy (EVT) experienced worse functional outcomes and a higher risk of mortality 90 days poststroke than patients without active cancer. Moores and Ganesh noted that these findings are consistent with results from the ESCAPE and ESCAPE-NA1 trials and it remains unclear how to identify patients who meet existing selection criteria for EVT but have no potential for benefit from EVT because they experience active cancer. They emphasized the importance of shared decision-making in these challenging situations, particularly when workup for acute stroke uncovers a new diagnosis of cancer. Verschoof et al. responded that the ESCAPE and ESCAPE-NA1 trials included 4 patients with cancer but did not comment on whether it was active. Because of the difficulty forming conclusions about the use of EVT in patients with active cancer through observational studies, they recommended the need for a controlled trial to study EVT in patients with active cancer.