A study changes in blood parameters of patients treated with targeted therapy for colon cancer

Abstract

Background: Colorectal cancer is the third most common cancer and the second leading cause of cancer death in the world. In 2021, colorectal cancer is the sixth most frequently diagnosed cancer and 278 new cases were registered in Mongolia. More than 80% of these diseases were diagnosed at a late stage1. Chemotherapy is the mainstay of treatment for late stage colorectal cancer. The reason for conducting this study is that no study has been conducted using Common Terminology Criteria for Adverse Events (CTCAE) when bevacizumab is used in combination with chemotherapy in Mongolian people. Aim: Comparison of blood parameters changes in patients with colorectal cancer treated with targeted therapy Materials and Methods: This study was performed retrospectively using a clinical case-control study design, using medical history and detailed blood analysis of patients with late-stage and metastatic colorectal cancer treated with FOLFIRI and A-FOLFIRI regimen. The results of the study were calculated by classifying the participants as follows: Group A: treated with FOLFIRI regimen, Group B: treated with Bevacizumab + FOLFIRI regimen Results: According to the CTCAE criteria, anemia was 61.67% and 62.90% in study groups A and B, grade I anemia was 36.67% and 27.42%, grade II anemia was 1.67% and 4.84%, grade III and grade IV anemia was found only in a group B, 3.23% (RR=0.83, 95% CI=0.64-1.08, p=0.17). Compared between the two study groups, thrombocytopenia and neutropenia were statistically significant (RR=1.21, 95%, CI=1.10-1.46, p=0.000) and higher in a group B. In the study participants, grade III thrombocytopenia was evaluated by CTCAE criteria in groups A and B, 5% and 11.29%, grade IV thrombocytopenia was 1.67% and 6.45%, respectively. Grade III neutropenia was in group A and B, 3.33% and 8.06%, grade IV neutropenia was 1.67% and 12.90%, respectively. Conclusion: In our study, mild anemia, thrombocytopenia, and neutropenia occurred in patients treated with standard chemotherapy based on irinotecan and fluorouracil. Adjunctive chemotherapy combined with bevacizumab (a targeted therapy), resulted in a significantly higher incidence of severe anemia, neutropenia, and thrombocytopenia compared with FOLFIRI regimen alone.