Serum Retinol, Alpha-Tocopherol and Systemic Inflammatory Response in Metastatic Colorectal Carcinoma Patients Treated with Combination Chemotherapy and Cetuximab

Abstract

Summary Cetuximab is a chimeric antibody registered for the therapy of advanced colorectal carcinoma. Cancer and anticancer therapy are associated with oxidative stress, and disorders of antioxidant balance may be involved in the toxicity associated with anticancer treatment. The aim of the present study was to investigate the changes of serum retinol, alpha-tocopherol and C-reactive protein during the first month of treatment with cetuximab and chemotherapy. Twenty-five consecutive patients with metastatic colorectal carcinoma treated with a combination of chemotherapy and cetuximab were included in the present study. Serum retinol and alpha-tocopherol were determined by high-performance liquid chromatography and serum C-reactive protein was determined using commercial kits. Significant correlation was observed between baseline concentrations of retinol and C-reactive protein ( r s ϭϪ 0.54, p Ͻ 0.01). Median survival of patients who had baseline serum retinol below 1.25 mol/L was 10 mo compared to 18 mo for patients who had serum retinol equal or above 1.25 mol/L ( p Ͻ 0.05); median survival of patients who had serum C-reactive protein below 24 mg/L was significantly longer compared to patients with C-reactive protein levels equal or above 24 mg/L (18 vs. 7 mo, p Ͻ 0.05), but no difference in survival was observed based on alpha-tocopherol levels. Twenty-two patients had evaluation of retinol, alpha-tocopherol and C-reactive protein at least once during the follow up. Serum concentration of alpha-tocopherol decreased significantly during the therapy, but retinol and Creactive protein concentrations remained unchanged. In conclusion, a significant correlation was observed between serum retinol and C-reactive protein. Serum alpha-tocopherol decreased significantly during the first month of combination therapy with cetuximab. Low retinol and high C-reactive protein concentrations were predictive of poor prognosis in this patient population.

Effect of Zinc Supplementation on Antioxidant Defenses and Oxidative Stress Markers in Patients Undergoing Chemotherapy for Colorectal Cancer: a Placebo-Controlled, Prospective Randomized Trial

“…This result is in agreement with those of studies showing that plasma vitamin E concentration decreases in patients submitted to chemotherapy for colorectal cancer [29,30] and following radiotherapy in head and neck squamous cell carcinoma patients [31]. Low α-tocopherol concentrations have been associated with advanced cancer [32] and chemotherapy toxicity [33].…”

C-Reactive Protein, Lipid-soluble Micronutrients, and Survival in Colorectal Cancer Patients

“…In particular, samples for the current study were obtained after completion of chemotherapy, consequently no conclusions can be drawn as to the benefit or harm associated with increased antioxidant levels during therapy. Melichar, et al [53] did report, however, similar results for a small group of patients (N = 25) in which baseline levels of retinol and CRP prior to therapy were also predictive of poor prognosis. A further limitation of the current study is the inability to adjust for socioeconomic status, which may impact nutrition and mortality through multiple mechanisms.…”

Association of peripheral blood cell count-derived ratios, biomarkers of inflammatory response and tumor growth with outcome in previously treated metastatic colorectal carcinoma patients receiving cetuximab

“…The changes and prognostic significance of urinary neopterin, serum magnesium, serum retinol, α-tocopherol and intestinal permeability, or complications of therapy in this cohort or its parts with a shorter follow-up have been reported earlier [16][17][18][19][20]. PBC with a manual differential count was determined as described earlier [21].…”