Effect of adjuvant chemotherapy on circulating levels of ICAM, VCAM, VEGF and VEGFD in women with lymph node positive breast cancer.(NOGGO trial)

Abstract

9602 Background: Intercellular adhesion molecule (ICAM), and vascular cell adhesion molecule (VCAM) play a role in cell adhesion to the vascular endothelium, and may have a role in tumour cell dissemination. Expression of Vascular Endothelial Growth Factor (VEGF) has been proposed as a prognostic indicator in breast cancer, because as one of the important factors involved in angiogenesis. Our aim of the present study was to investigate the effect of chemotherapy on plasma levels of ICAM, VCAM, VEGF und VEGFD in patients with breast cancer and to compare their levels among patients with different pathological features. Methods: Patients with resected breast cancer involving 1–3 axillary lymph nodes were treated in conventional 21d intervalls with ECT (Arm A): 4x epirubicin (90mg/m2, d1) /cyclophosphamide (600 mg/m2, d1) followed by 4x paclitaxel (175 mg/m2, d1). Arm B was treated with dose-dense ET in 14 days intervalls: 4x of epirubicin (120mg/m2, d1) followed by 4x paclitaxel (175 mg/m2, 3h, d1) with obligatory G-CSF support (5 mg/kg G-CSF d5–10). Blood samples of 83 patients (45 pat. Arm A, 38 pat. Arm B) were collected before chemotherapy (group BEFORE) and after administration of 8 cycle of adjuvant chemotherapy (group AFTER). Plasma levels of ICAM, VCAM, VEGF and VEGFD were measured with commercially available ELISA assays. Results: The plasma ICAM level before chemotherapy was significantly higher (p<0,017) in postmenopausal patients. The plasma VCAM level showed significant cross-correlation with VEGF (p<0,025) and VEGF-D levels (p<0,039) before chemotherapy. In addition, ICAM und VCAM levels after chemotherapy were significantly higher than ICAM (p<0,0001) and VCAM levels (p<0,001) before chemotherapy. Measured levels of VCAM after chemotherapy were significantly higher in ARM B with dose-intensification of ET. Conclusions: We conclude there are higher levels of adhesion molecules after chemotherapy and a cross-correlation to VEGF and VEGF-D. No significant financial relationships to disclose.