In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 30, No. 4_suppl ( 2012-02-01), p. 455-455
Abstract:
455 Background: The use of bevacizumab (BV), a monoclonal antibody against VEGF, and combination chemotherapy (CTx) together with an increase in hepatic resection has improved the outcome of colorectal cancer (CRC) patients with liver metastasis. However, despite the frequent use of BV, its accurate timing prior to liver resection to avoid surgical complications and to allow for hepatic regeneration remains discussed controversially. In this context, it remains unclear to which extent VEGF is complexed by BV at the time of surgery. Methods: Fifty CRC patients with liver metastases, potentially curable by resection, were included. Patients received neoadjuvant CTx either with or without concomitant biweekly BV. The last cycle of therapy did not include BV, resulting in 5 weeks between the last administration of BV and surgery. Plasma and wound fluid subcutaneously and intra-abdominally were obtained perioperatively. Immunoprecipitation was applied to determine the proportion of BV-bound VEGF. Results: 42 patients underwent surgery. Median time of BV cessation was 5-6 weeks. No increased perioperative complications in this BV treated patients were observed (patients without complications: 59 % of BV + CTx patients versus 50 % in CTx patients). At the time of surgery, the majority of plasma VEGF was inactivated by BV. In wound fluid, the actual site of wound healing and hepatic regeneration, VEGF was remarkably low and also complexed by BV. This resulted in a highly significant reduction of unbound/biologically active VEGF levels in plasma and wound fluid of BV treated patients (both: P 〈 0.001). Conclusions: These data documents that, after the clinical standard cessation time point of 5-6 weeks, BV is still fully active and binds to the majority of circulating and local (wound fluid) VEGF. Despite the potent VEGF inactivation, at the time of liver resection no substantial increase in perioperative morbidity after neoadjuvant BV therapy has been documented in our study and the current literature.
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/jco.2012.30.4_suppl.455
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2012
detail.hit.zdb_id:
2005181-5
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