Retrospective Cohort Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2024; 12(1): 15-23
Published online Jan 6, 2024. doi: 10.12998/wjcc.v12.i1.15
Evaluating combined bevacizumab and XELOX in advanced colorectal cancer: Serum markers carcinoembryonic antigen, carbohydrate antigen 125, carbohydrate antigen 199 analysis
Dong-Bing Zhou, Jun Cheng, Xiong-Hui Zhang
Dong-Bing Zhou, Department of Gastroenterology, The Second People's Hospital of Jingzhou Hubei, Jingzhou 434000, Hubei Province, China
Jun Cheng, Department of Gastrointestinal Surgery, Qianjiang Central Hospital, Qianjing 433100, Hubei Province, China
Xiong-Hui Zhang, Department of Gastroenterology, Xiantao First People's Hosepital Affiliated to Yangtze University, Xiantao 433000, Hubei Province, China
Co-first authors: Dong-Bing Zhou and Jun Cheng.
Author contributions: Zhou DB and Cheng J designed the research; Zhang XH, Zhou DB, and Cheng J performed the research; Zhang XH, Zhou DB, and Cheng J contributed new reagents/analytic tools; Zhang XH, Zhou DB, and Cheng J analyzed the data; Zhou DB and Cheng J wrote the paper; All authors were involved in the critical review of the results and have contributed to, read, and approved the final manuscript. Zhou DB and Cheng J contributed equally to this work as co-first authors equally to this work. The reasons for designating Zhou DB and Cheng J as co-first authors are threefold. First, the research was performed as a collaborative effort, and the designation of co-corresponding authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. This also ensures effective communication and management of post-submission matters, ultimately enhancing the paper's quality and reliability. Second, the overall research team encompassed authors with a variety of expertise and skills from different fields, and the designation of co-first authors best reflects this diversity. This also promotes the most comprehensive and in-depth examination of the research topic, ultimately enriching readers' understanding by offering various expert perspectives. Third, Zhou DB and Cheng J contributed efforts of equal substance throughout the research process. The choice of these researchers as co-first authors acknowledges and respects this equal contribution, while recognizing the spirit of teamwork and collaboration of this study. In summary, we believe that designating Zhou DB and Cheng J as co-first authors of is fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Institutional review board statement: This study protocol was approved by Xiantao First People's Hosepital Affiliated to Yangtze University, and all the families have voluntarily participated in the study and have signed informed consent forms.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors declared no conflict of interest existing in this paper.
Data sharing statement: Data generated from this investigation are available upon reasonable quest from the corresponding author.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiong-Hui Zhang, Attending doctor, Department of Gastroenterology, Xiantao First People's Hosepital Affiliated to Yangtze University, No. 29 Central Mianzhou Avenue, Xiantao 433000, Hubei Province, China. xionghui0708@sina.com
Received: October 30, 2023
Peer-review started: October 30, 2023
First decision: November 8, 2023
Revised: November 23, 2023
Accepted: December 18, 2023
Article in press: December 18, 2023
Published online: January 6, 2024
Abstract
BACKGROUND

Colorectal cancer ranks third and second among common and fatal cancers. The treatment of metastatic colorectal cancer (mCRC) is generally based on XELOX in clinical practice, which includes capecitabine (CAP) and oxaliplatin. Serum tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 125 and CA199 are prognostic factors for various tumors.

AIM

To investigate evaluating combined bevacizumab (BEV) and XELOX in advanced colorectal cancer: Serum markers CEA, CA125, CA199 analysis.

METHODS

In this retrospective study, a total of 94 elderly patients diagnosed with mCRC were recruited and subsequently categorized into two groups based on the distinct treatment modalities they received. The control group was treated with XELOX plus CAP (n = 47), while the observation group was treated with XELOX plus CAP and BEV (n = 47). Several indexes were assessed in both groups, including disease control rate (DCR), incidence of adverse effects, serum marker levels (CEA, CA125, and CA19) and progression-free survival (PFS).

RESULTS

After 9 wk of treatment, the serum levels of CEA, CA199 and CA125 in the observation group were significantly lower than those in the control group (P < 0.05). Moreover, the PFS of the observation group (9.12 ± 0.90 mo) was significantly longer than that of the control group (6.49 ± 0.64 mo). Meanwhile, there was no statistically significant difference in the incidence of adverse reactions and DCR between the two groups during maintenance therapy (P > 0.05).

CONCLUSION

On the basis of XELOX treatment, the combination of BEV and CAP can reduce serum tumor marker levels and prolong PFS in patients with mCRC.

Keywords: Metastatic colorectal cancer, Bevacizumab, Capecitabine, XELOX, Tumor markers

Core Tip: Colorectal cancer has a high incidence in the population. The clinical treatment of colorectal cancer is basically XELOX intervention. Prognostic determination of serum tumor markers is a common index to evaluate the efficacy of cancer drugs. Therefore, we studied the therapeutic effect and serum tumor markers of patients with colorectal cancer under different treatments. The results showed that the therapeutic effect of XELOX + capecitabine (CAP) + bevacizumab was better than that of XELOX + CAP, which showed that the serum carcinoembryonic antigen, carbohydrate antigen (CA) 199 and CA125 levels were lower and the median survival time was longer, and all of them were statistically significant.