Effect of bevacizumab on the development of oxaliplatin-associated liver injury in colorectal cancer liver metastasis

Abstract

Introduction: Oxaliplatin is an essential drug for treating colorectal liver metastasis (CRLM). Conversely, oxaliplatin has also been shown to cause sinusoidal injury (SI). Some authors previously reported that chemotherapy-associated SI increases the morbidity and mortality after liver resection due to an impaired remnant liver function. Therefore, it is important to prevent oxaliplatin-associated SI. Considering the estimated developmental mechanism of SI, a protective effect of bevacizumab is suggested. However, the effect of bevacizumab on the development of oxaliplatin-associated SI in CRLM remains unclear. The aim of this study was to clarify the effect of bevacizumab on the development of oxaliplatin-associated SI in CRLM. Method: Sixty-four patients undergoing liver resection for CRLM after oxaliplatin-based chemotherapy (OBC) were studied. They underwent pathological assessments to clarify the degree of histopathological liver injury of the nontumoral liver parenchyma. We divided the patients into the SI and non-SI group according to the pathological findings and compared the groups. Results: The median number of OBC cycles was 5.0 and duration of chemotherapy cessation was 7 weeks. Forty-seven patients (73.4%) received chemotherapy with bevacizumab. The non-SI group included 46 cases (71.9%) and the SI group included 18 cases. There were no significant differences between the two groups regarding sex, age, BMI and number of liver metastasis. The number of OBC cycles was more frequent in the SI group (p = 0.02), however, there was no difference in the duration of OBC cessation. Bevacizumab was more frequently administered in the non-SI group (p = 0.046). Conclusions: Bevacizumab may prevent oxaliplatin-associated SI in CRLM.