title: Serum homocysteine, cholesterol, retinol, alpha-tocopherol, glycosylated hemoglobin and inflammatory response during therapy with bevacizumab, oxaliplatin, 5-fluorouracil and leucovorin.
abstract: 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.
authors.affiliation: Department of Oncology, Palacký University Medical School and Teaching Hospital, Olomouc, Czech Republic. bohuslav.melichar@fnol.cz
authors.forename: Bohuslav
authors.initials: B
authors.lastname: Melichar
authors.forename: Hana
authors.initials: H
authors.lastname: Kalábová
authors.forename: Lenka
authors.initials: L
authors.lastname: Krcmová
authors.forename: Markéta
authors.initials: M
authors.lastname: Kasparová
authors.forename: Eva
authors.initials: E
authors.lastname: Malírová
authors.forename: Karolina
authors.initials: K
authors.lastname: Melicharová
authors.forename: Miroslav
authors.initials: M
authors.lastname: Pecka
authors.forename: Radomír
authors.initials: R
authors.lastname: Hyspler
authors.forename: Dagmar
authors.initials: D
authors.lastname: Solichová
mesh_terms: 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
chemical_list: 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