title: Daily low-dose/continuous capecitabine combined with neo-adjuvant irradiation reduces VEGF and PDGF-BB levels in rectal carcinoma patients.
abstract: Metronomic low-dose chemotherapy regimen was found to have an antiangiogenic effect in tumors. However, its effect on levels of circulating pro-angiogenic and anti-angiogenic factors is not fully explored.
  
  
  METHODS
  The levels of both VEGF and PDGF-BB were measured in three time points, in the serum of 32 rectal carcinoma patients receiving daily reduced-dose/continuous capecitabine in combination with preoperative pelvic irradiation.
  
  
  RESULTS
  We found a significant decrease in VEGF and PDGF-BB serum levels during the combination treatment (p < 0.0001), followed by an increase in the successive rest-period (p < 0.0001). In addition, substantial changes in platelets counts were observed during treatment in correlation with the changes of VEGF and PDGF-BB serum levels.
  
  
  CONCLUSIONS
  These results suggest that combined chemo-irradiation affect levels of pro-angiogenic factors during treatment, and may reflect an anti-angiogenic window induced during this treatment. The potential implications of this inducible phenomenon, including a possible clinical benefit from the administration of long lasting metronomic chemotherapy immediately following combined chemo-irradiation, would warrant further investigation.
authors.affiliation: Institute of Oncology, Ha'Emek Medical Center, Afula 18101, Israel. loven_da@clalit.org.il
authors.forename: David
authors.initials: D
authors.lastname: Loven
authors.forename: Einat
authors.initials: E
authors.lastname: Be'ery
authors.forename: Rinat
authors.initials: R
authors.lastname: Yerushalmi
authors.forename: Claude
authors.initials: C
authors.lastname: Koren
authors.forename: Aaron
authors.initials: A
authors.lastname: Sulkes
authors.forename: Idit
authors.initials: I
authors.lastname: Lavi
authors.forename: Yuval
authors.initials: Y
authors.lastname: Shaked
authors.forename: Eyal
authors.initials: E
authors.lastname: Fenig
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D000077214:Becaplermin; D000069287:Capecitabine; D002277:Carcinoma / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology / Q000532:radiotherapy; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D020360:Neoadjuvant Therapy; D009389:Neovascularization, Pathologic; D010388:Pelvis / Q000528:radiation effects*; D010982:Platelet-Derived Growth Factor / Q000187:drug effects / Q000378:metabolism* / Q000528:radiation effects; D020574:Proto-Oncogene Proteins c-sis; D012004:Rectal Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology / Q000532:radiotherapy; D013223:Statistics as Topic; D042461:Vascular Endothelial Growth Factor A / Q000097:blood* / Q000187:drug effects / Q000528:radiation effects
chemical_list: D000964:Antimetabolites, Antineoplastic; D010982:Platelet-Derived Growth Factor; D020574:Proto-Oncogene Proteins c-sis; D042461:Vascular Endothelial Growth Factor A; D003841:Deoxycytidine; D000077214:Becaplermin; D000069287:Capecitabine; D005472:Fluorouracil