title: Circulating levels of angiogenic cytokines in advanced breast cancer patients with system chemotherapy and their potential value in monitoring disease course.
abstract: OBJECTIVE
  The low-dose metronomic chemotherapy was reported to inhibit directly tumor angiogenesis or VEGF secretion. The study aimed to seek for this effect of system chemotherapy by observing the changes in serum levels of angiogenic cytokines during treatment and assessing their value in monitoring the advanced breast cancer.
  
  
  METHODS
  In sixty-one patients with advanced breast cancer, serum levels of vascular endothelial growth factor (VEGF) and endostatin (ES) were compared at baseline (B0), after one cycle (B1), after 3 cycles (B3), and after 5-6 cycles (B5-6) of system chemotherapy using a quantitative ELISA. Data were correlated with treatment response and total survival.
  
  
  RESULTS
  The response to chemotherapy did not correlate with serum VEGF level before therapy or after one cycle, but the changes in VEGF levels after 3 cycles and 5-6 cycles showed good association with clinical responses, i.e., the patients with disease control had a decreased VEGF value, whereas the progressive patients had an increased value. The Cox proportional hazard model revealed that a normalized VEGF level after therapy and an increase in VEGF level after 5-6 cycles were independent predictors for survival.
  
  
  CONCLUSIONS
  System chemotherapy for advanced breast cancer lead to a significant decrease in serum VEGF level in patients with disease control, and this anti-VEGF efficacy may be mainly due to the reduction in tumor burden. Sequential measurement of serum VEGF could be useful for evaluating treatment efficacy and prognosis.
authors.affiliation: Department of General Surgery, Jiangsu Cancer Hospital, Baziting 42, 210009 Nanjing, China.
authors.forename: Jin-Hai
authors.initials: JH
authors.lastname: Tang
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Zhao
authors.forename: Jian-Wei
authors.initials: JW
authors.lastname: Lu
authors.forename: Feng
authors.initials: F
authors.lastname: Yan
authors.forename: Jian-Wei
authors.initials: JW
authors.lastname: Qin
authors.forename: Bin
authors.initials: B
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D014408:Biomarkers, Tumor / Q000097:blood; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D043169:Endostatins / Q000097:blood*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000097:blood; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D043169:Endostatins; D042461:Vascular Endothelial Growth Factor A