title: Prognostic value of tumor growth factor levels during chemotherapy in patients with metastatic colorectal cancer.
abstract: Tumor growth and angiogenic factors are usually overexpressed in colorectal carcinomas. We aimed to assess the prognostic role of VEGF, bFGF, PDGF-AA, EGF, HGF, and E-selectin in patients with metastatic colorectal cancer treated with capecitabine and oxaliplatin (XELOX) chemotherapy protocol. Thirty-eight colorectal cancer patients who had evidence of distant metastasis were enrolled in the study. Angiogenic factors were measured before and after third cycle of chemotherapy. Patients were randomized into three groups, partial response (PR), stable disease (SD), and progressive disease (PD) groups, according to their clinical and radiologic evaluation after three cycles of XELOX chemotherapy. Eighteen patients (47.3 %) achieved partial response, 10 (26.3 %) stable disease, and 10 (26.3 %) progressive disease. VEGF (63.20 Pg/ml vs. 19,79 Pg/ml; p < 0.001), EGF (7.29 ± 3.08 Pg/ml vs. 4.79 ± 2.05 Pg/ml; p < 0.011), HGF (618.16 ± 340.39 Pg/ml vs. 452.02 ± 217.18 Pg/ml; p < 0.049), and PDGF-AA (691.68 ± 187.10 Pg/ml vs. 404.89 ± 168.47 Pg/ml; p < 0.001) were significantly decreased in PR group. PDGF-AA levels were also decreased in SD group (706.66 ± 206.66 Pg/ml vs. 389.79 ± 143.16 Pg/ml; p < 0,001). HGF levels were significantly increased in PD disease group (449.99 Pg/ml vs. 682.22 Pg/ml; p < 0.046). The baseline E-selectin levels were inversely proportional with overall survival that could be an important prognostic factor at the time of diagnosis. This study demonstrated that tumor growth factors can be helpful to determine colorectal cancer prognosis and overall survival in patients with metastatic disease. VEGF, HGF, EGF, and PDGF-AA levels were decreased in PR group. However, meaningful increment was seen HGF levels in PD group. Angiogenic factors and E-selectin provided unique prognostic information in advanced colorectal carcinoma patients.
authors.affiliation: Oncology Department, Mehmet Kemal Dedeman Onkoloji Hastanesi, Erciyes University, 38039, Kayseri, Turkey. mevludeinanc@hotmail.com
authors.forename: Mevlüde
authors.initials: M
authors.lastname: Inanç
authors.forename: Ozlem
authors.initials: O
authors.lastname: Er
authors.forename: Halit
authors.initials: H
authors.lastname: Karaca
authors.forename: Veli
authors.initials: V
authors.lastname: Berk
authors.forename: Metin
authors.initials: M
authors.lastname: Ozkan
authors.forename: Recep
authors.initials: R
authors.lastname: Saraymen
authors.forename: Ferhan
authors.initials: F
authors.lastname: Elmalı
mesh_terms: D043925:Angiogenesis Inducing Agents / Q000097:blood; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis*; D000069287:Capecitabine; D002277:Carcinoma / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D015179:Colorectal Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D003841:Deoxycytidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D019040:E-Selectin / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D004815:Epidermal Growth Factor / Q000097:blood; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000097:blood; D005472:Fluorouracil / Q000031:analogs & derivatives / Q000627:therapeutic use; D017228:Hepatocyte Growth Factor / Q000097:blood; D006801:Humans; D036341:Intercellular Signaling Peptides and Proteins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010071:Oxaloacetates; D010982:Platelet-Derived Growth Factor / Q000032:analysis; D011379:Prognosis; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D043925:Angiogenesis Inducing Agents; D014408:Biomarkers, Tumor; D019040:E-Selectin; D036341:Intercellular Signaling Peptides and Proteins; D010071:Oxaloacetates; D010982:Platelet-Derived Growth Factor; D042461:Vascular Endothelial Growth Factor A; C075278:platelet-derived growth factor A; D003841:Deoxycytidine; D016222:Fibroblast Growth Factor 2; D004815:Epidermal Growth Factor; D017228:Hepatocyte Growth Factor; D000069287:Capecitabine; D005472:Fluorouracil