Pro-Angiogenic Mediators as Targets for Chemotherapy of Colorectal Carcinoma

Purpose Angiogenesis and chronic inflammation are codependent in pathogenesis of colorectal carcinoma (CRC). We aim to assess whether vascular endothelial growth factor (VEGF), nitric oxide (NO) and total lipase (TL) activity being contributors to angiogenesis, are targets for CRC chemotherapy. Methods we enrolled 60 subjects, 20 volunteers (10 males and 10 females) were assigned as control (group I). Forty CRC patients, 20 locally advanced (group II), subjected to surgery and chemotherapy (5-fluorouracil (5-FU, 425 mg/m2) plus leucovorin (LV, 20 mg/m2), IV, daily for 5 consecutive days, repeated every 3 to 5 weeks for 6 courses). The other 20 patients, were metastatic, (group III), followed up, given only adjuvant chemotherapy. Results Serum carcino embryonic antigen (CEA), cancer antigen (CA19.9), VEGF, NO concentrations and TL activity were significantly elevated in CRC compared to control and in Gp III compared to Gp II patients, but were down-regulated by chemotherapy. VEGF, NO and TL helped in diagnosis and follow up of CRC, although they were not returned to reference intervals. In conclusion, the response to chemotherapy of VEGF, NO and TL substantiates an anti-angiogenic potential in controlling CRC. AFP level was not changed in secondary metastatic hepatocellular carcinoma (HCC), seemingly, it rises only in primary HCCs.