Gut peptide profile and chemotherapy-associated dyspepsia syndrome in patients with breast cancer undergoing FEC60 chemotherapy.
OBJECTIVE
The association of motilin, ghrelin, leptin, gastrin, pepsinogen (PG) I and II with cancer chemotherapy-associated dyspepsia syndrome (CADS) was investigated in 35 patients with breast cancer receiving first cycle of 5-fluorouracil, cyclophosphamide, epirubicin (FEC60) chemotherapy.


METHODS
The onset of dyspeptic symptoms on days 3 and 10 after chemotherapy identified patients with and without CADS. Gastrointestinal symptoms were scored with the Gastrointestinal Symptom Scoring Rate (GSRS) questionnaire. Gastrointestinal peptides were evaluated by enzyme-linked immunosorbent assay.


RESULTS
Twenty-one patients (60%) had CADS. The area under the curve (AUC) of ghrelin was higher, whereas that of PGI, PGII and motilin were lower in patients with CADS compared to those without. In patients with CADS, the AUC of PGI and PGII negatively correlated with the GSRS indigestion cluster.


CONCLUSIONS
Impairment of gastrointestinal motility suggested by low motilin concentrations and mucosal damage mirrored by an increase of ghrelin seem to be involved in the onset of CADS in patients during chemotherapy for breast cancer.
Laboratorio di Fisiopatologia della Nutrizione, I.R.C.C.S. Saverio De Bellis, via Turi 27, 70013 Castellana Grotte, Bari, Italy. francesco.russo@irccsdebellis.it.
Giuseppe
G
Riezzo
Caterina
C
Clemente
Michele
M
Linsalata
Benedetta
B
D'Attoma
Antonella
A
Orlando
Giovanna
G
Campanella
Francesco
F
Giotta
Francesco
F
Russo
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D018270:Carcinoma, Ductal, Breast / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000009:adverse effects; D004415:Dyspepsia / Q000139:chemically induced* / Q000378:metabolism; D015251:Epirubicin / Q000009:adverse effects; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects; D005500:Follow-Up Studies; D005755:Gastrins / Q000032:analysis; D005769:Gastrointestinal Motility / Q000187:drug effects*; D041981:Gastrointestinal Tract / Q000187:drug effects / Q000378:metabolism*; D054439:Ghrelin / Q000032:analysis; D006801:Humans; D020738:Leptin / Q000032:analysis; D008875:Middle Aged; D009037:Motilin / Q000032:analysis; D009367:Neoplasm Staging; D020116:Pepsinogen A / Q000032:analysis; D020115:Pepsinogen C / Q000032:analysis; D010446:Peptide Fragments / Q000032:analysis*; D011379:Prognosis; D011446:Prospective Studies; D013577:Syndrome
D005755:Gastrins; D054439:Ghrelin; D020738:Leptin; D010446:Peptide Fragments; D015251:Epirubicin; D009037:Motilin; D020115:Pepsinogen C; D003520:Cyclophosphamide; D020116:Pepsinogen A; D005472:Fluorouracil
Adjuvant chemotherapy; breast cancer; dyspepsia; gastrin; ghrelin; leptin; motilin; pepsinogens