Abstract
ABSTRACT Introduction Bevacizumab is a humanized monoclonal antibody that targets vascular endothelial growth factor-A and has clear efficacy in the treatment of metastatic colorectal cancer. However, the evaluation of response to angiogenesis inhibitors and the prognosis of the patients not always correlate directly with RECIST criteria. Recently, two studies have suggested that pre-treatment lactate dehydrogenase (LDH) levels correlated with objective response and prognosis of metastatic colorectal cancer patients treated with bevacizumab, and that the changes in CEA and CA19.9 could be an early sign of progression in this group of patients. The aim of this study is to explore the role of pre-treatment LDH, CEA and CA 19.9 serum levels in metastatic colorectal cancer patients receiving first-line bevacizumab, specifically the correlation with objective response and the impact on overall survival (OS) and progression-free survival (PFS). Methods Retrospective review of 41 metastatic colorectal cancer patients treated with first-line association of bevacizumab/FOLFIRI (infusional 5-fluorouracil, folinic acid, irinotecan), between 2006 and 2011, with collection of demographic data, date of diagnosis, treatment, objective response to treatment, date of progression, last visit or date of death and pre-treatment LDH, CEA and CA 19.9 serum levels. OS and PFS were calculated according to the Kaplan-Meier method. Differences in survival were considered significant when p Results Median OS and PFS were similar for patients with high and normal LDH levels (28 and 9 months, respectively). For patients with high and normal levels of CEA, the median OS was 28 and 26 months, respectively, and the median PFS was 10 and 9 months, respectively, without statistical significance. For patients with high and normal levels of CA 19.9, the median OS was 26 and 28 months, respectively, without statistical significance; the median PFS was similar in both groups (9 months). Baseline high levels of LDH, CEA and CEA 19.9 didnt correlate with a worse result in terms of objective response to treatment. Conclusion In this study, pre-treatment LDH, CEA and CA 19.9 serum levels in metastatic colorectal cancer patients receiving first-line bevacizumab didnt significantly correlate with objective response, OS and PFS, fact that could be explained by the small size of the sample.
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