Investigation of morphological and functional changes in the liver and pancreas during bevacizumab treatment

Abstract

Objectives: Recently, there have been reports regarding the atrophy of various organs caused by molecular targeted drugs. We investigated morphological and clinical changes in the liver and pancreas caused by treatment with bevacizumab.

Methods: We investigated 30 patients with colorectal cancer who received bevacizumab-containing chemotherapy (study group) and 11 patients with colorectal cancer who received chemotherapy without bevacizumab (control group) from 2010 to 2014. We obtained computed tomography data of the liver and pancreas and performed three-dimensional image analysis and volumetry. Laboratory data before and after chemotherapy were analyzed.

Results: There was no significant difference in liver volume before and after bevacizumab-containing chemotherapy, but the pancreatic volume was found to be significantly reduced after bevacizumab-containing chemotherapy (57.9 ± 16 mL versus 47.4 ± 15.3 mL; p = .005). The liver and pancreatic volume did not change statistically in the control group. With regard to complete blood cell counts and laboratory data, no significant differences were observed in the leukocyte count and hemoglobin, hemoglobin A1c, triglyceride, albumin, and C-reactive protein levels. In contrast, there was a significant decrease in the platelet count, total cholesterol level and a significant increase in the amylase level. A chemotherapy regimen that included bevacizumab reduced pancreatic volume and significantly altered the morphology of the pancreas.

Conclusions: Although bevacizumab caused atrophy of the pancreas and reduced pancreatic volume, pancreatic endocrine function showed no change. Future studies should investigate the survival rate and functional changes caused by bevacizumab treatment.

Keywords:

• Colorectal cancer
• bevacizumab
• pancreatic atrophy
• liver volume
• pancreatic endocrine function
• imaging

Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

Author contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Yukio Oshiro, Kiyotaka Nishida, Jiro Shimazaki, Mitsugi Shimoda, and Shuji Suzuki. The first draft of the manuscript was written by Yukio Oshiro, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This work was supported by Department of Gastroenterological Surgery, Ibaraki Medical Center, Tokyo Medical University.