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Srpski arhiv za celokupno lekarstvo 2016 Volume 144, Issue 11-12, Pages: 615-620
https://doi.org/10.2298/SARH1612615D
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Biochemical liver function test parameter levels in relation to treatment response in liver metastatic colorectal patients treated with FOLFOX4 with or without bevacizumab

Denić Kristina (Military Medical Academy, National Poison Control Center, Department of Toxicological Chemistry, Belgrade)
Tarabar Dino (Military Medical Academy, Clinic for Gastroenterology, Belgrade + University of Defense, Faculty of Medicine, Military Medical Academy, Belgrade)
Obradović Slobodan ORCID iD icon (University of Defense, Faculty of Medicine, Military Medical Academy, Belgrade + Military Medical Academy, Clinic for Emergency Medicine, Belgrade)
Ristić Marija (Institute for Oncology and Radiology, Belgrade)
Spasić Jelena ORCID iD icon (Institute for Oncology and Radiology, Belgrade)
Radosavljević Davorin (Institute for Oncology and Radiology, Belgrade)
Ugrešić Nenad (Faculty of Pharmacy, Belgrade)

Introduction. Combined use of bevacizumab and conventional anticancer drugs leads to a significant improvement of treatment response in patients with metastatic colorectal carcinoma (CRC). Conventional treatment protocols exert undesired effects on the liver tissue. Hepatotoxic effects are manifested as a disturbance of liver function test parameters. The relation between clinical outcome and disorder of biochemical parameters has not been completely evaluated. Objective. The objective of our study was to examine whether clinical outcome in patients with liver metastatic CRC correlates with the level of liver function test parameters. Methods. The study included 96 patients with untreated liver metastatic CRC who received FOLFOX4 protocol with or without bevacizumab. Biochemical liver parameters were performed before and after the treatment completion. Treatment response was evaluated as disease regression, stable disease, and disease progression. The patients were divided into three groups according to the accomplished treatment response. Results. In the group of patients with disease regression the post-treatment levels of aspartate aminotransferase, alanine aminotransferase, and bilirubin were statistically significantly increased. In contrast to this, gamma-glutamyltransferase and protein post-treatment values were significantly lower in relation to initial values. In patients with stable disease, difference was found only in the level of proteins being lower after the treatment. In patients with disease progression, values of aspartate aminotransferase and bilirubin were significantly increased after completed treatment. Conclusion. Treatment responses are not completely associated with the level of liver function test parameters. The only parameter which correlated with treatment response is gamma-glutamyltransferase. Its decrease is accompanied with disease regression.

Keywords: bevacizumab, colorectal liver metastases, hepatotoxicity, liver function test parameters, treatment response