Gut peptide profile and chemotherapy-associated dyspepsia syndrome in patients with breast cancer undergoing FEC60 chemotherapy

Anticancer Res. 2013 Nov;33(11):4951-7.

Abstract

Aim: The association of motilin, ghrelin, leptin, gastrin, pepsinogen (PG) I and II with cancer chemotherapy-associated dyspepsia syndrome (CADS) was investigated in 35 patients with breast cancer receiving first cycle of 5-fluorouracil, cyclophosphamide, epirubicin (FEC60) chemotherapy.

Patients and methods: The onset of dyspeptic symptoms on days 3 and 10 after chemotherapy identified patients with and without CADS. Gastrointestinal symptoms were scored with the Gastrointestinal Symptom Scoring Rate (GSRS) questionnaire. Gastrointestinal peptides were evaluated by enzyme-linked immunosorbent assay.

Results: Twenty-one patients (60%) had CADS. The area under the curve (AUC) of ghrelin was higher, whereas that of PGI, PGII and motilin were lower in patients with CADS compared to those without. In patients with CADS, the AUC of PGI and PGII negatively correlated with the GSRS indigestion cluster.

Conclusion: Impairment of gastrointestinal motility suggested by low motilin concentrations and mucosal damage mirrored by an increase of ghrelin seem to be involved in the onset of CADS in patients during chemotherapy for breast cancer.

Keywords: Adjuvant chemotherapy; breast cancer; dyspepsia; gastrin; ghrelin; leptin; motilin; pepsinogens.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Breast Neoplasms / complications
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / metabolism
  • Carcinoma, Ductal, Breast / complications
  • Carcinoma, Ductal, Breast / drug therapy*
  • Carcinoma, Ductal, Breast / metabolism
  • Chemotherapy, Adjuvant
  • Cyclophosphamide / adverse effects
  • Dyspepsia / chemically induced*
  • Dyspepsia / metabolism
  • Epirubicin / adverse effects
  • Female
  • Fluorouracil / adverse effects
  • Follow-Up Studies
  • Gastrins / analysis
  • Gastrointestinal Motility / drug effects*
  • Gastrointestinal Tract / drug effects
  • Gastrointestinal Tract / metabolism*
  • Ghrelin / analysis
  • Humans
  • Leptin / analysis
  • Middle Aged
  • Motilin / analysis
  • Neoplasm Staging
  • Pepsinogen A / analysis
  • Pepsinogen C / analysis
  • Peptide Fragments / analysis*
  • Prognosis
  • Prospective Studies
  • Syndrome

Substances

  • Gastrins
  • Ghrelin
  • Leptin
  • Peptide Fragments
  • Epirubicin
  • Motilin
  • Pepsinogen C
  • Cyclophosphamide
  • Pepsinogen A
  • Fluorouracil

Supplementary concepts

  • FEC protocol