Hemangiogenic response after pre-operative COX2 inhibition predicts recurrence in esophageal cancer

15077 Background: Growth of esophageal cancer involves a proliferative hemangiogenic component. Biomarkers that predict this propensity in esophageal cancer and the impact of anti-angiogenic strategy on their levels as well as clinical response remain unknown. Methods: A multimodular approach was devised to assess hemangiogenic parameters in a cohort of chemotherapy naïve patients with locally advanced (T2-T3N0, T1-T3N1M0M1a) esophageal cancer pre- and 4 days post-celecoxib neoadjuvant treatment. Patients went on to receive neoadjuvant therapy with celecoxib, paclitaxel and carboplatin for 3 cycles, followed by surgical resection. This bioassay panel consists of 5 components: i) HUVEC-based angiogenic scale for functional plasma angiogenic activity, ii) flow cytometry to quantify CD133+VEGFR2+ circulating endothelial progenitors (CEPs), iii) hematopoietic colony-forming assay to quantify circulating hematopoietic progenitors (CHPs), iv) plasma SDF-1 level, and v) platelet VEGF-A level. Results: The cohort consists of 8 consecutive patients (6 men, 2 women) with median age of 58. After 18 months of followup, 6 patients remained alive and without evidence of recurrence, while 2 had tumor recurrence and metastasis. Analysis of the positive responders (pre-celecoxib baseline versus 4 days post treatment) revealed a global suppression of hemangiogenic parameters with reduction of the functional HUVEC-based angiogenic scale (mean score of 3.3 versus 1.8; p<0.05), 2.2-fold decrease in CEPs (p<0.05), and 3-fold decrease in CHPs (p<0.05). This trend also correlated with decreased plasma SDF-1 and platelet VEGF-A levels . However, in the 2 cases of tumor recurrence, the initial hemangiogenic response was blunted with no significant difference in all parameters tested during the celecoxib monotherapy period. Conclusion: Esophageal cancer development involved a hemangiogenic switch toward increased CEPs, CHPs, and functional plasma pro-angiogenic activity. COX2 inhibition with celecoxib normalized the hemangiogenic profile. Collective assessment of hemangiogenic biomarkers during neoadjuvant setting may be a promising tool in predicting clinical outcomes, recurrence, and for validating impact of anti-angiogenic therapy on esophageal cancer. No significant financial relationships to disclose.

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PS01.196: SHORT-TERM AND MEDIUM-TERM OUTCOMES IN PATIENTS OVER 70 DIAGNOSED WITH OESOPHAGEAL CANCER

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps01.196 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 105-105

Author(s):

Anantha Madhavan ◽

Nicola Wyatt ◽

Charlotte Boreham ◽

Alexander Phillips ◽

S Michael Griffin

Keyword(s):

Oesophageal Cancer ◽

Conflicts Of Interest ◽

Locally Advanced ◽

Neoadjuvant Treatment ◽

Major Complication ◽

Radio Therapy ◽

Significant Difference ◽

Group A ◽

Group B ◽

The Impact

Abstract Background Oesophageal cancer incidence has increased over the last decade in the UK, particularly in older patients. Surgery, with or without perioperative chemotherapy, remains the gold standard treatment for patients with potentially curable disease. Currently, 41% of new cases of oesophageal cancer are in patients aged over 70. However, only 10% underwent surgery compared to 25% of those aged under 70. Concerns exist that advanced age may prejudice treatment decisions. The aim of our review is to evaluate the impact of age on outcomes in those undergoing planned curative treatment for oesophageal cancer. Methods A retrospective review of patients undergoing oesophagectomy for carcinoma between 2006 to 2016 at a single institution was performed. Patients were divided into two cohorts based on age at the time of diagnosis; under 70 years (Group A) and over 70 (Group B). Patients underwent a standardised staging protocol and treatment was decided by a multi-disciplinary team. Oesophagectomy was performed using a transthoracic approach with two field lymphadenectomy and perioperative chemo (radio) therapy used in those patients with locally advanced disease who were fit enough. Results There were 555 patients in Group A and 241 in Group B. Adenocarcinoma was the prevalent histological subtype in both cohorts: 76% (423) in Group A and 68% (165) in Group B. Median age at the time of diagnosis was 62 in Group A versus 74 in Group B. In Group A, 12% (18/343) did not receive neo-adjuvant treatment for locally advanced cancer versus 47% (101/212) in Group B (P < 0.001). Median hospital stay was longer in Group B (18 v 15 days P = 0.02). There was no significant difference in hospital mortality (Group A 1% vs Group B 2.4% P = 0.37) and major complication rate (Group A 14% vs Group B 20% P = 0.31). Two-year survival was 66% (adenocarcinoma) and 78% (SCC) in Group A compared to 60% (adenocarcinoma) and 64% (SCC) in Group B. Conclusion These results demonstrate that patients over 70 can be treated successfully with minimal additional risk to morbidity and mortality. However, these patients are more likely to be denied neoadjuvant treatment which may compromise their long-term outcomes. Disclosure All authors have declared no conflicts of interest.

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P-OGC17 Feasibility and impact of a home-based prehabilitation programme on patients receiving neoadjuvant treatment for oesophagogastric cancer (the chemofit study)

British Journal of Surgery ◽

10.1093/bjs/znab430.145 ◽

2021 ◽

Vol 108 (Supplement_9) ◽

Author(s):

Jakub Chmelo ◽

Alexander W Phillips ◽

Alastair Greystoke ◽

Sarah J Charman ◽

Leah Avery ◽

...

Keyword(s):

Negative Impact ◽

Locally Advanced ◽

Neoadjuvant Treatment ◽

Cardiopulmonary Exercise Testing ◽

Mean Difference ◽

Step Count ◽

Post Intervention ◽

Home Based ◽

Significant Difference ◽

The Impact

Abstract Background Treatment for locally advanced oesophagogastric adenocarcinoma (OGA) involves neoadjuvant chemotherapy (NAC) which has a negative impact on patient fitness. Using ‘prehabilitation’ to increase activity levels and fitness may affect physiology, postoperative outcomes and improve patient wellbeing and quality of life. The aim of this study was to evaluate feasibility, acceptability and the impact of a home-based structured prehabilitation programme in OGA. Methods This feasibility study recruited consecutive patients to a pragmatic home-based prehabilitation during NAC. Participants completed daily walking sessions to a targeted step-count and daily strengthening exercises, under the weekly supervision of the research team. The primary outcomes assessed feasibility through recruitment rate, completion rate and individual compliance with each component of the intervention. Secondary outcomes included fitness derived from cardiopulmonary exercise testing (CPET). Results A total of 42/58(72%) patients approached were recruited, 36/39(92%) patients completed the programme. Median compliance with wearing a pedometer and recording step count was 97.8%(IQR 93.2-100%) and median engagement with telephone contacts was 100%(IQR 93.1-100%). Median compliance with 30-minutes aerobic exercise was 70.2%(IQR 53.1-88.9%) and for strength exercises 69.4%(IQR 52.1-84.3%). Nineteen patients had pre and post intervention CPET with no significant difference in anaerobic threshold (mean difference -0.5 ml.kg-1.min-1, 95% CI -1.6 to + 0.6, p = 0.387) or VO2peak (mean difference -0.1 ml.kg-1.min-1, 95% CI -1.6 to + 1.4, p = 0.883). Conclusions This study shows that ChemoFit is feasible, safe and achieved excellent patient compliance and engagement. Future utilisation of this home-based prehabilitation programme may improve preoperative fitness during NAC and impact post-operative outcomes.

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PS02.162: THREE-YEAR OVERALL SURVIVAL UPDATE FROM PHASE II STUDY OF CHEMOSELECTION WITH DCF AND SUBSEQUENT CONVERSION SURGERY FOR LOCALLY ADVANCED UNRESECTABLE ESOPHAGEAL CANCER

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps02.162 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 167-168

Author(s):

Tomoya Yokota ◽

Ken Kato ◽

Yasuo Hamamoto ◽

Yasuhiro Tsubosa ◽

Hirofumi Ogawa ◽

...

Keyword(s):

Overall Survival ◽

Esophageal Cancer ◽

Phase Ii ◽

Locally Advanced ◽

R0 Resection ◽

Conversion Surgery ◽

Significant Difference ◽

Subsequent Conversion ◽

The Impact

Abstract Background A multicenter phase II trial revealed that docetaxel plus 5-fluorouracil and cisplatin (DCF) induction chemotherapy (IC) and subsequent conversion surgery (CS) was tolerable and effective in patients with locally advanced unresectable esophageal cancer (LAUEC) (Br J Cancer 2016;115:1328–1334). Here, we report updated 3-year analyses to further characterize the impact of DCF-IC followed by CS. Methods Esophageal cancer patients with clinical T4 disease and/or unresectable supraclavicular lymph node metastasis were eligible. The treatment starts with 3 cycles of DCF-IC, followed by CS if resectable, or by concurrent radiation plus chemotherapy with 5-fluorouracil and cisplatin (CF-RT) if not resectable. This updated analysis represents 3-year overall survival (OS), 3-year progression free survival (PFS), location of relapse, and subsequent therapy. Results As of October 11, 2017, 25 patients were dead. The median follow-up period in patients surviving without death was 39.3 months (95%CI: 38.7 - 41.7months). The estimated 1-year OS was 66.7% and lower limit of 95% confidence interval was 54.6%. The estimated 3-year OS was 46.6% (95% CI; 34.2 - 63.5%). The OS for patients who underwent R0 resection (n = 19) was significantly longer than those who did not undergo R0 resection (3-year OS: 71.4% vs. 30.1%). The estimated 1-year PFS was 50.6% (95%CI: 38.1 - 67.3%) and the estimated 3-year PFS was 39.6% (95%CI: 27.7 - 56.6%). The PFS for patients who underwent R0 resection (n = 19) was significantly longer than those who did not undergo R0 resection (3-year PFS: 61.3% vs. 25%). The recurrence or progression in primary site was observed in 31% of non R0 group. There was no significant difference in the rates of distant metastasis between the two groups (non R0 group vs. R0 group; 21% vs. 16%). The subsequent therapy after protocol therapy included chemotherapy (n = 18), radiotherapy (n = 11), and surgery (n = 5). Conclusion This longer follow up of DCF-IC followed by CS strategy for patients with LAUEC revealed promising OS and PFS. Based on this phase 2 trial, JCOG1510, a prospective randomized controlled trial to compare chemoselection with DCF-IC followed by CS versus CF-RT as a standard treatment is in preparation for LAUEC. Disclosure All authors have declared no conflicts of interest.

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Long-term outcomes of clinical and pathological-staged T3 N3 esophageal cancer

Diseases of the Esophagus ◽

10.1093/dote/doz109 ◽

2020 ◽

Vol 33 (8) ◽

Cited By ~ 2

Author(s):

S K Kamarajah ◽

N Newton ◽

M Navidi ◽

S Wahed ◽

A Immanuel ◽

...

Keyword(s):

Esophageal Cancer ◽

Neoadjuvant Therapy ◽

Locally Advanced ◽

Neoadjuvant Treatment ◽

Stage Migration ◽

Term Survival ◽

Carcinoma Of The Esophagus ◽

Dismal Prognosis ◽

The Impact

Summary Locally advanced esophageal cancer is associated with poor long-term survival. Pre- and post-treatment stages may differ because of neoadjuvant therapy and inaccuracies in staging. The aim of this study was to determine the outcomes of patients staged with clinical T3 N3 and pathological T3 N3 carcinoma of the esophagus and determine differences between the groups. Consecutive patients from a single unit between 2010 and 2018 were included with either clinical (cT3 N3) or pathological (pT3 N3) esophageal cancer. Outcomes were compared between patients that underwent esophagectomy with or without neoadjuvant treatment and those patients staged cT3 N3 treated non-surgically (NSR). Patients were staged using the TNM 8. This study included 156 patients, 63 patients were staged cT3 N3 initially and had NSR treatment, only three of these had radical treatment. Of the remaining 93 patients who underwent esophagectomy, 34 were initially staged as cT3 N3, 54 were found to be pT3 N3 having been staged earlier initially, and five were unchanged before and after treatment. Median overall survival (OS) for surgical cT3 N3 patients was significantly longer than pT3 N3 and NSR (median: NR vs 19 vs 8 months, P < 0.001). Twenty-seven patients with cT3 N3 had lower staging following treatment, while three had a higher stage. T3 N3 disease carries a poor prognosis. Within this cohort, cT3 N3 disease treated surgically has a high 5-year OS suggesting possible over-staging and stage migration due to neoadjuvant therapy. Those not having surgery, have a dismal prognosis. The impact of neoadjuvant treatment cannot be predicted and, current staging modalities may be inaccurate. Clinical stage should be used with caution when counseling patients regarding management and prognosis.

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Role of 18F-PET-CT to predict pathological response after neoadjuvant treatment of rectal cancer

Discover Oncology ◽

10.1007/s12672-021-00405-w ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Riccardo Caruso ◽

Emilio Vicente ◽

Yolanda Quijano ◽

Hipolito Duran ◽

Isabel Fabra ◽

...

Keyword(s):

Rectal Cancer ◽

Fdg Pet ◽

Locally Advanced ◽

Neoadjuvant Treatment ◽

Standardized Uptake Value ◽

Tumour Regression Grade ◽

Pet Ct ◽

Significant Difference ◽

18F Fdg ◽

Fdg Pet Ct

Abstract Objectives Neoadjuvant chemoradiation (nCRT) is universally considered to be a valid treatment to achieve downstaging, to improve local disease control and to obtain better resectability in locally advanced rectal cancer (LARC). The aim of this study is to correlate the change in the tumour 18F-FDG PET-CT standardized uptake value (SUV) before and after nCRT, in order to obtain an early prediction of the pathologic response (pR) achieved in patients with LARC. Data description We performed a retrospective analysis of patients with LARC diagnosis who underwent curative resection. All patients underwent a baseline 18F-FDG PET-CT scan within the week prior to the initiation of the treatment (PET-CT SUV1) and a second scan (PET-CT SUV2) within 6 weeks of the completion of nCRT. We evaluated the prognostic value of 18F-FDG PET-CT in terms of disease-free survival (DFS) and overall survival (OS) in patients with LARC.A total of 133 patients with LARC were included in the study. Patients were divided in two groups according to the TRG (tumour regression grade): 107 (80%) as the responders group (TRG0-TRG1) and 26 (25%) as the no-responders group (TRG2-TRG3). We obtained a significant difference in Δ%SUV between the two different groups; responders versus no-responders (p < 0.012). The results of this analysis show that 18F-FDG PET-CT may be an indicator to evaluate the pR to nCRT in patients with LARC. The decrease in 18F-FDG PET-CT uptake in the primary tumour may offer important information in order for an early identification of those patients more likely to obtain a pCR to nCRT and to predict those who are unlikely to significantly regress.

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The Impact of IDH1 Mutation and MGMT Promoter Methylation on Recurrence-Free Interval in Glioblastoma Patients Treated With Radiotherapy and Chemotherapeutic Agents

Pathology & Oncology Research ◽

10.3389/pore.2021.1609778 ◽

2021 ◽

Vol 27 ◽

Author(s):

Maher Kurdi ◽

Nadeem Shafique Butt ◽

Saleh Baeesa ◽

Badrah Alghamdi ◽

Yazid Maghrabi ◽

...

Keyword(s):

Promoter Methylation ◽

Tumor Recurrence ◽

Dna Methyltransferase ◽

Chemotherapeutic Agents ◽

Idh1 Mutation ◽

Treatment Modalities ◽

Isocitrate Dehydrogenase 1 ◽

Free Interval ◽

Significant Difference ◽

The Impact

The aim of this study is to investigate the relationship between isocitrate dehydrogenase-1 (IDH1) mutation and O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation with recurrence-free interval in glioblastoma patients treated with chemoradiotherapies. Clinical data were collected from 82 patients with totally resected glioblastoma and treated with adjuvant therapies from 2014 to 2019. IDH1 mutation was assessed by immunohistochemistry and MGMT promoter methylation was assessed by different sequencing methods. IDH1 mutation was present in 32 cases and 50 cases were IDH1 wildtype; 54 and 28 patients had unmethylated and methylated MGMT promoter, respectively, Of the 82 patients, 62 patients received chemoradiotherapy while 20 patients only received radiation. Approximately, 61% of patients had a tumor recurrence after 1 year, and 39% showed a recurrence before 1 year of treatment. There was no significant relationship between IDH1 mutation and MGMT promoter methylation (p-value = 0.972). Patients with IDH1 mutation and their age <50 years showed a significant difference in recurrence-free interval (p-value = 0.014). Difference in recurrence-free interval was also statistically observed in patients with unmethylated MGMT promoter and treated with chemoradiotherapies (p-value = 0.031), by which they showed a late tumor recurrence (p-value = 0.016). This revealed that IDH1 mutation and MGMT methylation are independent prognostic factors in glioblastoma. Although IDH1-mutant glioblastomas showed late tumor recurrence in patients less than 50 years old, the type of treatment modalities may not show additional beneficial outcome. Patients with unmethylated MGMT and IDH1 mutation, treated with different chemoradiotherapies, showed a late tumor recurrence.

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Role of 18F-PET-CT to Predict Pathological Response After Neoadjuvant Treatment of Rectal Cancer

10.21203/rs.3.rs-143636/v1 ◽

2021 ◽

Author(s):

Riccardo Caruso ◽

Emilio Vicente ◽

Yolanda Quijano ◽

Hipolito Duran ◽

Isabel Fabra ◽

...

Keyword(s):

Rectal Cancer ◽

Fdg Pet ◽

Locally Advanced ◽

Neoadjuvant Treatment ◽

Standardized Uptake Value ◽

Disease Free Survival ◽

Pet Ct ◽

Significant Difference ◽

18F Fdg ◽

Fdg Pet Ct

Abstract Objectives: Neoadjuvant radiochemotherapy (nCRT) is universally considered to be a valid treatment to achieve downstaging, improve local disease control and obtain better resectability in locally advanced rectal cancer (LARC). The aim of this study is to correlate the change in tumor 18F -FDG PET-CT standardized uptake value (SUV) before and after nCRT, in order to obtain an early prediction of pathologic response (pR) achieved in patients with LARC.Data description: We performed a retrospective analysis of patients with LARC diagnosis who underwent curative resection. All patients received nCRT and surgical treatment was carried after 8/12th. All patients underwent a baseline 18F -FDG PET-CT scan within the week prior to the initiation of the treatment (PET-CT SUV1) and a second scan (PET-C T SUV2) within six weeks of the completion of nCRT. Furthermore, we evaluated the prognostic value of 18F -FDG PET-CT in terms of disease free survival (DFS) and overall survival (OS) in patients with LARC.A total of 133 patients with LARC were included in the study. Patients were divided in two groups according to the TRG (tumor regression grade): 107 (80%) as Responders group (TRG0-TRG1) and 26 (25%) as the No-Responders group (TRG2-TRG3). We obtained a significant difference in Δ%SUV between the two different groups responders vs no responders (p<0.012).The results of this analysis have shown that 18F-FDG PET-CT may be an indicator in order to evaluate the pR to nCRT in patients with LARC. The decrease in 18F-FDG PET-CT uptake in the primary tumor may offer primary information in order to early identify those patients more likely to obtain a pCR to nCRT and predict those unlikely to regress significantly.

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Neoadjuvant treatment strategy for locally advanced thoracic esophageal cancer

Annals of Gastroenterological Surgery ◽

10.1002/ags3.12243 ◽

2019 ◽

Vol 3 (3) ◽

pp. 269-275 ◽

Cited By ~ 7

Author(s):

Shuhei Mayanagi ◽

Tomoyuki Irino ◽

Hirofumi Kawakubo ◽

Yuko Kitagawa

Keyword(s):

Esophageal Cancer ◽

Treatment Strategy ◽

Locally Advanced ◽

Neoadjuvant Treatment ◽

Thoracic Esophageal Cancer

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Long-term outcomes of omentum-preserving versus resecting gastrectomy for locally advanced gastric cancer with propensity score analysis

Scientific Reports ◽

10.1038/s41598-020-73367-8 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Yusuke Sakimura ◽

Noriyuki Inaki ◽

Toshikatsu Tsuji ◽

Shinichi Kadoya ◽

Hiroyuki Bando

Keyword(s):

Gastric Cancer ◽

Propensity Score ◽

Advanced Gastric Cancer ◽

Missing Values ◽

Propensity Score Analysis ◽

Locally Advanced ◽

R0 Resection ◽

Significant Difference ◽

First Recurrence ◽

The Impact

Abstract Omentectomy is conducted for advanced gastric cancer (AGC) patients as radical surgery without an adequate discussion of the effect. This study was conducted to reveal the impact of omentum-preserving gastrectomy on postoperative outcomes. AGC patients with cT3 and 4 disease who underwent total or distal gastrectomy with R0 resection were identified retrospectively. They were divided into the omentum-preserved group (OPG) and the omentum-resected group (ORG) and matched with propensity score matching with multiple imputation for missing values. Three-year overall survival (OS) and 3-year relapse-free survival (RFS) were compared, and the first recurrence site and complications were analysed. The numbers of eligible patients were 94 in the OPG and 144 in the ORG, and after matching, the number was 73 in each group. No significant difference was found in the 3-year OS rate (OPG: 78.9 vs. ORG: 78.9, P = 0.54) or the 3-year RFS rate (OPG: 77.8 vs. ORG: 68.2, P = 0.24). The proportions of peritoneal carcinomatosis and peritoneal dissemination as the first recurrence site and the rate and severity of complications were similar in the two groups. Omentectomy is not required for radical gastrectomy for AGC.

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Effect of bevacizumab (BV) and chemotherapy (CT) on serum levels of vascular endothelial growth factor receptor-2 (sVEGFR-2) in patients with inflammatory and locally advanced breast cancer

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.13003 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 13003-13003

Author(s):

J. M. Walshe ◽

N. Denduluri ◽

A. W. Berman ◽

D. Nguyen ◽

S. Y. Yang ◽

...

Keyword(s):

Breast Cancer ◽

Wound Healing ◽

Locally Advanced Breast Cancer ◽

Locally Advanced ◽

Neoadjuvant Treatment ◽

Statistical Testing ◽

Reference Sequence ◽

Tissue Samples ◽

Significant Difference ◽

Wound Healing Problems

13003 Background: VEGFR-2 is a principal mediator of angiogenesis. The effects on sVEGFR-2 after anti-angiogenesis therapy are unknown. Methods: Twenty-one patients (pts) with breast cancer underwent neoadjuvant treatment with BV for 1 cycle (C1) followed by 6 cycles of BV, CT and filgrastim. Blood was collected at baseline (BL), post-cycles 1, 4 and 7. Objectives were to correlate sVEGFR-2 changes after treatment with response, assess wound healing complications, and evaluate for tumor VEGFR-2 mutations. sVEGFR-2 levels were measured by ELISA. Exons 17–26 were sequenced on tissue samples from 20 pts at BL and post C1 to evaluate for VEGFR-2 mutations. Statistical testing is non-parametric. All p-values are two-tailed, with a p < 0.01 interpreted as a statistically significant difference. Results: Thirteen pts had a partial response (PR), 1 unconfirmed PR, 5 stable disease (SD), and 2 progressive disease (PD). Median sVEGFR-2 levels increased by 16% from BL to post C1 (p = 0.0003) and decreased by 19% post C1 to post C4 (p = 0.048). sVEGFR-2 levels were not associated with clinical response. sVEGFR-2 levels at BL did not correlate with other BL parameters: Ki67, microvessel density, VEGF-A, pVEGFR-2, VEGFR-2 or TUNEL (apoptosis). A moderate-weak correlation was seen between post C1 levels of sVEGFR-2 and pVEGFR-2 (r = 0.43). A moderate inverse correlation was seen in the relative difference of sVEGFR-2 and TUNEL from BL to post C1 (r = −0.59). Comparing pts with (n = 5) and without (n = 16) wound healing problems, median sVEGFR-2 levels were 11322 ng/ml and 7524 ng/ml at BL (p = 0.019), 13928 ng/ml and 10148 ng/ml post C1 (p = 0.029), and 10965 ng/ml and 7932 ng/ml post C4 (p = 0.042). In 40 samples where tumor VEGFR-2 sequencing was obtained, no mutations were seen compared to the reference sequence. Conclusion: sVEGFR-2 levels rose significantly following BV alone but were not associated with response. There is a suggestion that sVEGFR-2 may correlate with activated VEGFR2 and a decrease in apoptosis. sVEGFR-2 levels were higher in pts with wound healing problems and may predict pts at higher risk of this complication. There were no mutations of VEGFR2. [Table: see text]

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