VAB-6 chemotherapy causes spurious elevation of alpha-fetoprotein associated with liver dysfunctions.
In order to elucidate the mechanism of elevation of alpha-fetoprotein (AFP) which we often observed during VAB-6 chemotherapy, we analyzed sequential changes of AFP, liver enzymes and bilirubin in 10 patients with evaluable disseminated testicular cancer who were treated with VAB-6 chemotherapy. None of the patients had previous liver disease or hepatic involvement. During the early phase of each course of chemotherapy, AFP showed a temporary elevation associated with reversible increase in liver enzymes and bilirubin. These changes returned to normal before the next course of chemotherapy. In each patient, marked tumor regression occurred as a result of VAB-6 chemotherapy. Nine of the 10 patients remain free of disease after treatment. We conclude that during VAB-6 chemotherapy, a temporary elevation of AFP is common, associated with reversible liver dysfunctions, and that this spurious elevation of the tumor marker, most likely caused by a heavy dose of cisplatin, should not be interpreted as related treatment failure.
Hida
S
S
Department of Urology, Faculty of Medicine, Kyoto University, Japan.
Nishimura
K
K
Nishio
Y
Y
Oishi
K
K
Takeuchi
H
H
Yoshida
O
O
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001219:Aspartate Aminotransferases / Q000097:blood; D014408:Biomarkers, Tumor; D001761:Bleomycin / Q000008:administration & dosage; D056486:Chemical and Drug Induced Liver Injury; D002945:Cisplatin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003609:Dactinomycin / Q000008:administration & dosage; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008107:Liver Diseases / Q000097:blood; D008297:Male; D013736:Testicular Neoplasms / Q000097:blood / Q000188:drug therapy; D014747:Vinblastine / Q000008:administration & dosage; D000509:alpha-Fetoproteins / Q000378:metabolism*
D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins; D001761:Bleomycin; D003609:Dactinomycin; D014747:Vinblastine; D003520:Cyclophosphamide; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D002945:Cisplatin