title: Serum vascular endothelial growth factor as a predictor of response and survival in patients with advanced hepatocellular carcinoma undergoing hepatic arterial infusion chemotherapy.
abstract: BACKGROUND
  Hepatic arterial infusion chemotherapy (HAIC) has been recognized as a useful therapeutic modality for patients with advanced hepatocellular carcinoma (HCC). The aim of this study was to investigate the association between serum vascular endothelial growth factor (VEGF) levels and the therapeutic effect of HAIC and the survival of patients undergoing HAIC.
  
  
  METHODS
  Seventy-one patients with advanced HCC underwent HAIC through a subcutaneously implanted infusion port. One chemotherapy course consisted of low-dose cisplatin (10 mg/body on days 1-5) and 5-fluorouracil (250 mg/body on days 1-5), and 1 treatment cycle consisted of 2-3 courses of chemotherapy. Serum VEGF levels were measured with the Bio-Plex Suspension Array System (Bio-Rad Laboratories).
  
  
  RESULTS
  The median survival time (MST) of all patients was 10.2 months, and the 1-, 2-, 3-, and 5-year survival rates were 46.5, 21.9, 12.8, and 3.7%, respectively. Of the 71 patients, 3 achieved a complete response (CR) and 22 achieved a partial response (PR) [response rate (CR + PR/71) = 35%]. The serum VEGF level (≥100 pg/mL, P = 0.026) was an independent predictor of therapeutic effect, and was positively correlated with the platelet count (r = 0.569, P < 0.001) and tumor size (r = 0.543, P < 0.001). Child-Pugh class (P = 0.046), serum VEGF level (P = 0.004), and therapeutic effect (P = 0.005) were identified by multivariate analysis as independent predictors of survival.
  
  
  CONCLUSIONS
  These results demonstrate that the serum VEGF level in patients with advanced HCC undergoing HAIC is an important predictive factor for therapeutic effect and survival.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan. niizeki_takashi@kurume-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Niizeki
authors.forename: Shuji
authors.initials: S
authors.lastname: Sumie
authors.forename: Takuji
authors.initials: T
authors.lastname: Torimura
authors.forename: Junichi
authors.initials: J
authors.lastname: Kurogi
authors.forename: Ryoko
authors.initials: R
authors.lastname: Kuromatsu
authors.forename: Hideki
authors.initials: H
authors.lastname: Iwamoto
authors.forename: Hajime
authors.initials: H
authors.lastname: Aino
authors.forename: Masahito
authors.initials: M
authors.lastname: Nakano
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawaguchi
authors.forename: Tatsuyuki
authors.initials: T
authors.lastname: Kakuma
authors.forename: Michio
authors.initials: M
authors.lastname: Sata
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood; D010976:Platelet Count; D011379:Prognosis; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D002945:Cisplatin; D005472:Fluorouracil