Basal proteinuria as a prognostic factor in patients with metastatic colorectal cancer treated with bevacizumab.
BACKGROUND
The beneficial effects of bevacizumab, a widely used agent in metastatic colorectal cancer (mCRC), on clinical survival have been proven. This study investigated the correlation of the clinical benefits and prognosis with proteinuria and other parameters.


METHODS
The study included mCRC patients receiving bevacizumab. Hypertension, 24-hour urine proteinuria, and other routine parameters were recorded at baseline and at certain intervals during treatment.


RESULTS
The study included 36 consecutive patients. The median progression-free survival (PFS) duration was 10.9±2.6months, and the median overall survival (OS) was 23±3.1months. The median PFS was 7.2months among patients with basal proteinuria above 114mg/day, whereas the median PFS was 12months among patients with an equal or lower level (P=0.010). Similarly, PFS was shorter in patients with high lactate dehydrogenase (LDH) or carcinoembryonic antigen (CEA) levels (LDH, P=0.022; CEA, P=0.014). Bevacizumab response's performance status was good (P=0.05) and was even better in patients with a single liver metastasis (P=0.034) or hypertension (P=0.034).


CONCLUSIONS
We demonstrated that high basal proteinuria, LDH, or CEA levels may be negative prognostic factors in mCRC patients receiving bevacizumab.
Afyon Kocatepe University Faculty of Medicine, Department of Medical Oncology, Izmir Karayolu 8.km, 03200 Afyon, Turkey. Electronic address: mukreminuysal@yahoo.com.
Mukremin
M
Uysal
Akdeniz University Faculty of Medicine, Department of Medical Oncology, Antalya, Turkey.
Hakan
H
Bozcuk
Akdeniz University Faculty of Medicine, Department of Medical Oncology, Antalya, Turkey.
Sema
S
Sezgin Göksu
Akdeniz University Faculty of Medicine, Department of Medical Oncology, Antalya, Turkey.
Ali
A
Murat Tatli
Akdeniz University Faculty of Medicine, Department of Medical Oncology, Antalya, Turkey.
Deniz
D
Arslan
Akdeniz University Faculty of Medicine, Department of Medical Oncology, Antalya, Turkey.
Seyda
S
Gündüz
Akdeniz University Faculty of Medicine, Department of Medical Oncology, Antalya, Turkey.
Hasan
H
Senol Coskun
Medstar Antalya Hospital, Department of Medical Oncology, Antalya, Turkey.
Mustafa
M
Ozdogan
Akdeniz University Faculty of Medicine, Department of Medical Oncology, Antalya, Turkey.
Burhan
B
Savas
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008113:Liver Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D011446:Prospective Studies; D011507:Proteinuria / Q000473:pathology*; D013997:Time Factors; D016896:Treatment Outcome
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D002272:Carcinoembryonic Antigen; D000068258:Bevacizumab; D007770:L-Lactate Dehydrogenase
Bevacizumab; Metastatic colorectal cancer; Prognostic and predictive factors; Proteinuria