Changes in the Circulating Plasma Levels of VEGF and VEGF-D after Adjuvant Chemotherapy in Patients with Breast Cancer and 1 to 3 Positive Lymph Nodes

Abstract

Background: The goal of the present study was to investigate the changes in concentration of the important lymph-angiogenesis factors vascular endothelium-derived growth factor (VEGF) and VEGF-D under adjuvant chemotherapy. Materials and Methods: The blood plasma of a total of 142 patients with breast carcinoma and with 1 to 3 affected lymph nodes was investigated, using the quantitative sandwich enzyme immunoassay technique, prior to and following chemotherapy, within the framework of a randomized phase III study: the patients received either conventional or dose-intensified chemotherapy. Results: In general, there was a significant reduction in VEGF levels after chemotherapy only in patients with large tumors (T3) (p=0.043). There was also an almost significant reduction in patients with an overexpression of c-erbB-2 (Dako Score +3, p=0.052). In contrast, the clearest reduction in VEGF-D occurred in patients with a positive hormone receptor status (p=0.04) or in patients with a low expression of c-erbB-2 (Dako Score +1, p=0.05). A significant effect of chemotherapy on VEGF-D was determined only in patients who had a baseline level that was above the normal (conventionel treatment p=0.005; dose-intensified treatment p=0.004). Conclusion: Both VEGF and VEGF-D levels changed after chemotherapy, depending on the patient and tumor characteristics. With respect to changes in the plasma levels of VEGF and VEGF-D, there were no significant differences between dose-intensified and conventional chemotherapy.