Gastroduodenal, intestinal and colonic permeability during anticancer therapy.

BACKGROUND/AIMS: Measurement of the permeability of gut mucosa may offer a method for objective assessment of mucosal dysfunction during cancer therapy.

METHODOLOGY

Gastroduodenal, intestinal and colonic permeability was studied by using capillary gas chromatography and measuring urinary sucralose, sucrose, lactulose, xylose and mannitol levels. A total of 41 patients with metastatic colorectal carcinoma or epithelial ovarian carcinoma were studied before and during chemotherapy with the combinations of cetuximab, irinotecan, 5-fluorouracil and leucovorin; bevacizumab, oxaliplatin, 5-fluorouracil and leucovorin; or paclitaxel/ platinum.

RESULTS

Compared to pretreatment values, a significant increase was observed during the first cycle of therapy in the percentage of sucrose, sucrose/mannitol ratio, lactulose and lactulose/ mannitol ratio in patients treated with the combination of bevacizumab, oxaliplatin, 5-fluorouracil and leucovorin. No changes were observed in patients treated with cetuximab, irinotecan, 5-fluorouracil and leucovorin, but these patients had significantly higher baseline percentage of lactulose excretion and sucrose/mannitol and lactulose/ mannitol ratios.

CONCLUSIONS

An increase in gastroduodenal and intestinal permeability was observed in patients treated with bevacizumab, oxaliplatin, 5-fluorouracil and leucovorin, but not in patients treated with cetuximab, irinotecan, 5-fluorouracil and leucovorin. No significant increase in colonic permeability was observed, but the present method was insufficient to detect colonic permeability in a significant proportion of patients.