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 (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 (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