Urinary Neopterin, Serum Retinol, α-tocopherol and Homocysteine in Breast Cancer Patients During Treatment with Bevacizumab and Chemotherapy

Abstract

Bevacizumab, monoclonal antibody targeting vascular endothelial growth factor, is effective in different tumors, including colorectal carcinoma, non-small cell lung cancer, renal cell carcinoma and breast cancer. Increased serum or urinary concentrations of neopterin, an indicator of systemic immune response, have been described in patients with tumors of different primary locations, and further increase has been observed during anticancer therapy. An increase of urinary neopterin has been described after administration of cytokines, cytotoxic chemotherapy, or external beam radiation, but less is known about the effects of targeted agents on systemic immune response. We have studied serum homocysteine, C-reactive protein, α-tocopherol and retinol, and urinary neopterin in patients with metastatic breast cancer treated with bevacizumab, taxane and carboplatin. Homocysteine and C-reactive protein were determined immunochemically. α-tocopherol, retinol and urinary neopterin were determined by high performance liquid chromatography. Homocysteine, C-reactive protein and urinary neopterin decreased, while retinol and α-tocopherol increased during the therapy. In conclusion, the treatment of patients with metastatic breast cancer with bevacizumab, taxane and carboplatin resulted in the suppression of systemic inflammatory and immune response. The suppression of systemic inflammatory and immune response was associated with an increase in serum vitamin concentrations.

Long-term significance of urinary neopterin in ovarian cancer: a study by the Austrian Association for Gynecologic Oncology (AGO)

“…The fact that most VEGF in the tumor microenvironment is considered to originate from tumorassociated macrophages could constitute a plausible link between high urinary neopterin levels and proangiogenic subtype ovarian cancers. The findings of Melichar et al [23] also indicate a link between VEGF and urinary neopterin.…”

Identification of Immuno-Inflammation-Related Biomarkers for Acute Myocardial Infarction Based on Bioinformatics

“…88 Surprisingly, some in vitro and in vivo studies reported that bevacizumab could treat atherosclerosis by inhibiting neovascularization and decreasing total and LDL cholesterol and homocysteine. 89,90 However, some researches reported that systemic VEGF inhibition accelerated atherosclerosis, disrupted endothelial homeostasis, and increased hypertension and arterial thrombotic events. 91,92 Some scientists attempted to use special carriers to transport drug to atheromatous sites precisely.…”

Deep Vein Thrombosis in Pregnancy and Postpartum: Are Sulfur-Containing Amino Acids Involved in Thrombophilia Condition?

“…Both points of view bring scientific arguments and, against the fact that the controversy continues, it is generally accepted that homocysteine is involved in vascular endothelial dysfunction and promotes thrombosis [41][42][43]. The literature mentions many diseases in which elevated homocysteine concentrations have been found in the blood: cardiovascular diseases [36,[44][45][46][47][48], neurological diseases [49][50][51][52], miscarriage [53][54][55], thrombophilia [56][57][58][59][60][61], bone fragility [62][63][64][65][66][67], diabetes [68][69][70][71][72][73][74], inflammation [75][76][77].…”