title: The role of VEGF and other parameters in tracking the clinical course in metronomic chemotherapy.
abstract: OBJECTIVE
  The purpose of this study was to investigate the effect of metronomic chemotherapy on serum vascular endothelial growth factor (VEGF) levels in cancer patients.
  
  
  METHODS
  The study included 11 metastatic cancer patients who received daily 50 mg cyclophosphamide and biweekly 5 mg methotrexate per os as metronomic chemotherapy. Bevacizumab together with FOLFIRI chemotherapy was administered as anti-angiogenic treatment in another group of 16 metastatic colorectal carcinoma patients. Furthermore, VEGF levels of 10 healthy individuals and 5 cord blood samples served for comparisons. VEGF levels of patients before therapy and 3 months after treatment were analyzed and compared.
  
  
  RESULTS
  Serum VEGF levels prior to metronomic chemotherapy were higher compared with the healthy controls (p=0.0001). Similarly, serum VEGF levels prior to the bevacizumab-based chemoimmunotherapy were significantly higher compared with the healthy controls (p=0.005). In patients on metronomic chemotherapy VEGF levels showed non significant decrease (p=0.075). On the contary, VEGF levels decreased significantly (p=0.002) with bevacizumab treatment.
  
  
  CONCLUSIONS
  Serum VEGF levels may be used for assessing of the efficacy of anti-angiogenic therapies.
authors.forename: D
authors.initials: D
authors.lastname: Ekinci
authors.affiliation: Department of Medical Oncology, Akdeniz University Faculty of Medicine, Antalya, Turkey.
authors.forename: D
authors.initials: D
authors.lastname: Ekici
authors.forename: A
authors.initials: A
authors.lastname: Kargi
authors.forename: A D
authors.initials: AD
authors.lastname: Yalcin
authors.forename: A
authors.initials: A
authors.lastname: Didem Yalcin
authors.forename: B
authors.initials: B
authors.lastname: Savas
mesh_terms: D059250:Administration, Metronomic; D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D000068258:Bevacizumab; D014408:Biomarkers, Tumor / Q000097:blood*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000098:blood supply / Q000188:drug therapy* / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D014408:Biomarkers, Tumor; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D003520:Cyclophosphamide; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin; D008727:Methotrexate