Basal VEGF-A and ACE Plasma Levels of Metastatic Colorectal Cancer Patients Have Prognostic Value for First-Line Treatment with Chemotherapy Plus Bevacizumab

• Published in: Cancers Vol. 14; no. 13; p. 3054
• Main Authors: Ortiz-Morales, M. José, Toledano-Fonseca, Marta, Mena-Osuna, Rafael, Cano, M. Teresa, Gómez-España, Auxiliadora, Haba-Rodríguez, Juan R. De la, Rodríguez-Ariza, Antonio, Aranda, Enrique
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 21.06.2022; MDPI
• Subjects: Aldosterone; Angiogenesis; Angiotensin; Antiangiogenic agents; Bevacizumab; Biomarkers; Cancer; Cancer therapies; Chemotherapy; Clinical medicine; Colorectal cancer; Colorectal carcinoma; Disease management; Localization; Medical prognosis; Metastases; Metastasis; Patients; Peptidyl-dipeptidase A; Plasma; Plasma levels; Renin; Risk groups; Statistical analysis; Survival; Vascular endothelial growth factor; Spain
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers14133054

The identification of factors that respond to anti-angiogenic therapy would represent a significant advance in the therapeutic management of metastatic-colorectal-cancer (mCRC) patients. We previously reported the relevance of VEGF-A and some components of the renin–angiotensin-aldosterone system (RAAS) in the response to anti-angiogenic therapy in cancer patients. Therefore, this prospective study aims to evaluate the prognostic value of basal plasma levels of VEGF-A and angiotensin-converting enzyme (ACE) in 73 mCRC patients who were to receive bevacizumab-based therapies as a first-line treatment. We found that high basal VEGF-A plasma levels were significantly associated with worse overall survival (OS) and progression-free survival (FPS). On the other hand, low ACE levels were significantly associated with poor OS. Importantly, a simple scoring system combining the basal plasma levels of VEGF-A and ACE efficiently stratified mCRC patients, according to OS, into high-risk or low-risk groups, prior to their treatment with bevacizumab. In conclusion, our study supports that VEGF-A and ACE may be potential biomarkers for selecting those mCRC patients who will most benefit from receiving chemotherapy plus bevacizumab treatment in first-line therapy. Additionally, our data reinforce the notion of a close association between the RAAS and the anti-angiogenic response in cancer.