90y Mikroküre Tedavisinde Anjiyojenik Faktör Düzeyleri ile Prognoz Arasındaki İlişkinin Araştırılması

Abstract

Tumor angiogenesis is a crucial process in cancer and one of the main determinants of the growth, invasion and metastasis potential of the tumor. Better-performing markers are needed for patient selection and prognosis estimation in 90Y microsphere treatment and angiogenic factors are quite promising in this context. Aim of this prospective study was to evaluate the angiogenic response and to analyze the prognostic value of circulating angiogenic factor levels and their changes after 90Y microsphere treatment. Twenty-two patients with primary or metastatic liver cancer were included in this study. Blood samples were collected from all patients at different time points (on the day before the treatment and days 1,7 and 30 after treatment) and levels of some angiogenic factors (IL-6, IL-8, Ang-2, osteopontin, VEGF-A, HGF, PDGF-BB) were measured from these samples. All patients underwent anatomic (CT and/or MRI) and molecular ([18F]FDG PET/CT) imaging to assess therapy response and overall survival, early treatment responses in treated liver region, progression status in non-treated liver region and extrahepatic regions were analysed with the use of mRECIST and PERCIST criteria along with clinical follow-up. The results showed that overall survival times of patients with disease control (partial response and stable disease) in treated liver region, without progression in non-treated liver region and without progression in any extrahepatic region were significantly longer than that of other patients. Ang-2 levels on days 1 and 7 were significantly lower in patients with progression in non-treated liver region. Osteopontin levels at day 30 were significantly higher in patients with extrahepatic progression. Percentage ratio of the changes in Ang-2 levels from baseline to day 1 and from day 1 to day 30 were significantly different between patients with and without progression in non-treated liver regions. Likewise, ratio of the changes in PDGF-BB levels from baseline to day 1 were significantly different between patients with and without progression in non-treated liver regions. In conclusion; Ang-2, osteopontine and PDGF-BB may have an impact for prognostic assessment in 90Y microsphere therapy, where circulating levels of Ang-2 and osteopontin at different time points and percentage ratio of change in Ang-2 and PDGF-BB levels among different time points after 90Y microsphere treatment can perform well to differentiate patients with respect to prognosis.