Serum Uric Acid and C-reactive Protein in Patients with Metastatic Colorectal Carcinoma During Combination Therapy with High-dose Folinic Acid

Abstract

New spectrum of side effects has emerged with the introduction of targeted therapies, including changes in parameters determining cardiovascular risk. Among other laboratory parameters, hyperuricemia and elevated Creactive protein (CRP) are associated with increased risk of cardiovascular disease. The aim of the present study was to investigate the changes of serum uric acid and CRP during the therapy with cetuximab, combined with 5- fluorouracil and high-dose folinic acid, in patients with metastatic colorectal carcinoma and the association of these changes with the outcome of the therapy. CRP and uric acid were determined using particle-enhanced immunoturbidimetric assay and uricase method, respectively. Measurements before and during the treatment were compared by Wilcoxon signed rank test, and comparison between survivors and non-survivors was performed by Mann-Whitney U test. Compared to baseline (pre-treatment) concentrations, serum uric acid was decreased significantly throughout the course of the combination treatment with irinotecan, 5-fluorouracil, highdose folinic acid and cetuximab. The decrease was evident early in the course of treatment. Serum CRP was also decreased significantly throughout the most of the course of therapy. The significant decrease of serum uric acid and CRP was evident already one week after the start of treatment. Serum CRP was significantly lower in patients who survived 12 months, but no difference of uric acid concentrations between survivors and non-survivors was found. A marked decrease of serum uric acid was observed during the combination therapy. High CRP was associated with poor prognosis, but no association between uric acid and prognosis was noted.

Keywords

• c-reactive protein
• colorectal carcinoma
• cetuximab
• uric acid