Serum homocysteine, cholesterol, retinol, alpha-tocopherol, glycosylated hemoglobin and inflammatory response during therapy with bevacizumab, oxaliplatin, 5-fluorouracil and leucovorin.
BACKGROUND
Targeted agents present with a new spectrum of side-effects, including toxicities that negatively impact the risk of atherosclerosis. The aim of the present study was to evaluate the effect of the combination of targeted therapy and chemotherapy on serum homocysteine and other laboratory parameters of cardiovascular risk in patients with metastatic colorectal carcinoma.


METHODS
Thirty-one patients with metastatic colorectal carcinoma treated with the combination of bevacizumab, oxaliplatin, 5-fluorouracil and leucovorin were studied before and during the therapy.


RESULTS
Serum homocysteine decreased significantly throughout the course of treatment. Total cholesterol and low-density lipoprotein cholesterol also decreased significantly during the first month of therapy. In contrast, serum retinol significantly increased during the second and third months of treatment. A significant increase in glycosylated hemoglobin was also observed. After an initial rise, serum C-reactive protein (CRP) and carcinoembryonic antigen (CEA) were significantly lower compared to baseline throughout the course of treatment. Serum ferritin increased throughout most of the course of treatment. A significant correlation was observed between CRP and high-density lipoprotein cholesterol, retinol, ferritin, and CEA. CEA correlated with hemoglobin, retinol, and ferritin. Retinol correlated significantly with hemoglobin.


CONCLUSIONS
Tumor control, reflected in lower CEA, resulted in suppression of the acute phase response and generally in favorable effects on laboratory parameters indicative of risk factors of atherosclerosis, including lower homocysteine concentrations, and lower total and LDL cholesterol.
Melichar
Bohuslav
B
Department of Oncology, Palacký University Medical School and Teaching Hospital, Olomouc, Czech Republic. bohuslav.melichar@fnol.cz
Kalábová
Hana
H
Krcmová
Lenka
L
Kasparová
Markéta
M
Malírová
Eva
E
Melicharová
Karolina
K
Pecka
Miroslav
M
Hyspler
Radomír
R
Solichová
Dagmar
D
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D050197:Atherosclerosis / Q000097:blood* / Q000139:chemically induced; D000068258:Bevacizumab; D002784:Cholesterol / Q000097:blood; D015179:Colorectal Neoplasms / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006442:Glycated Hemoglobin / Q000378:metabolism; D006710:Homocysteine / Q000097:blood; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D014801:Vitamin A / Q000097:blood; D024502:alpha-Tocopherol / Q000097:blood
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D002784:Cholesterol; D005472:Fluorouracil; D006442:Glycated Hemoglobin; D006710:Homocysteine; D002955:Leucovorin; D009944:Organoplatinum Compounds; D014801:Vitamin A; D024502:alpha-Tocopherol