Therapy with DNA damaging drugs of a small number of non-metastatic and metastatic colorectal cancer patients ISSN 2753-8176 (online)

Therapy with DNA damaging drugs of a small number of non-metastatic and metastatic colorectal cancer patients

Ana Pedro (1)

1. Gwyntwr1386 Pharmacy, Regus Chester Business Park, Heronsway,Chester CH4 9QR, United Kingdom info@gwyntwr1386.com

Introduction and results

Colorectal cancer (CRC) is the third most common malignancy and the second most deadly cancer, inducing estimated 1.9 million incidence cases and 0.9 million deaths worldwide in 2020 (1). Each year, approximately, 230,000 patients are treated with adjuvant chemotherapy (AT) (2) . Nine patients with non-metastatic (NM) and metastatic (M) CRC were treated with 5-fluorouracil (5-FU)/leucovorin (LV) (LV5FU) regimen (3), 3 patients with M disease with FOLFOX (folinic acid (leucovorin, FOL), fluorouracil (5-FU, F), and oxaliplatin (Eloxatin, OX) (4) and 2 patients with NM and M disease were treated with XELOX regimen (capecitabine (trade name Xeloda) combined with oxaliplatin (5) (tables 1 and 2). All the patients treated with the LV5FU and FOLFOX regimens were disease-free after chemotherapy. However, a patient with metastasis in the liver treated with the XELOX regimen showed no improvement after chemotherapy. 5FU induces Id1-2 expression and Id2 is expressed in most CRC liver metastases (6). P53 overexpression causes a decrease in the scores of hemoglobin beta and hemoglobin alpha in primary CRC cell lines (7). In stage III there are decreases in the scores of hemoglobin beta and hemoglobin alpha. P53 knockout causes increases in all proteins scores. As in stage III there are decreases in the scores of hemoglobin beta and hemoglobin alpha, perhaps this explains the efficacy of adjuvant chemotherapy at this stage (7, 8) and chemotherapy efficacy for stages I, II and III is related both with P53 induction by different chemotherapeutic agents (Fig.1) and decreases in the scores of hemoglobin beta and hemoglobin alpha at stage III (7).

Material and Methods

16 patients (10 men and 6 women) were submitted to the following treatments: 5FU/FV (9 patients), Irinotecan+5FU/FV (1 patient), FOLFOX (3 patients), and XELOX (2 patients) between 1997 and 2007. Patients were evaluated by PET, CT scan, and CA 19-9, etc. The present work was authorized by the Macedo de Cavaleiros Hospital Ethical Commission (Portugal). We thank Miguel Afonso (Pharmacist), Dr. Moreira Pinto (medical oncologist), Lidia Santos and Cristina Neto (Pharmacists), as well as nurses Cacilda Pacheco, Maria Ines Faleiro and Maria do Carmo Santos for their help.

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