Bevacizumab improves splenomegaly and decreases production of hyaluronic acid after L-OHP based chemotherapy.

BACKGROUND: Oxaliplatin-based chemotherapy can cause hepatic sinusoidal injury such as sinusoidal obstructive syndrome (SOS). Spleen size is correlated with sinusoidal damage, and serum hyaluronic acid is also a marker of SOS. The aim of the present study was to clarify the impact of the current chemotherapeutic regimen plus bevacizumab against oxaliplatin-associated hepatic damage with serum hyaluronic acid and spleen size.

PATIENTS AND METHODS: Sixteen adult patients with colorectal cancer and liver metastasis were evaluated retrospectively. In the bevacizumab-treated group (n=9), oxaliplatin-based chemotherapy with bevacizumab prior to hepatic resection was administered, while oxaliplatin-based chemotherapy-alone was administered prior to hepatic resection in the control group (n=7). Hepatic sinusoidal injury, change in spleen size and serum value of hyaluronic acid were evaluated.

RESULTS: The incidence and severity of sinusoidal dilation was lower in the bevacizumab group than in the control group (moderate or severe: 2/9 (22.2%) vs. 5/7 (71.4%), incidence of sinusoidal dialation: 5/9 (55.6%) vs. 7/7 (100%), both p<0.05). The change in spleen size and serum hyaluronic acid were significantly lower in the bevacizumab-treated group compared to the control group (change in spleen size: 110.3%±27.5% vs. 146.3%±34.2%, hyaluronic acid: 33.6±21.2 ng/ml vs. 124.5±34.0 ng/ml, both p<0.05).

CONCLUSION: In the current study, bevacizumab reduced SOS in pathological findings and suppressed the elevation of hyaluronic acid, and splenomegaly. In addition, a change in spleen size and serum hyaluronic acid could serve as a biomarker for a predictive effect of bevacizumab against SOS.