Abstract:

Objective To study the effect of bevacizumab treatment on the lipid levels in ovarian epithelial cancer patients and its correlation with prognosis. Methods The clinical and laboratory determination data of 198 patients with ovarian epithelial cancer who were treated in the Affiliated Hospital of Inner Mongolia University for Nationalities from January 2019 to February 2023 were analyzed retrospectively. A total of 84 patients were treated with paclitaxel+platinum，and the remaining 114 patients were treated with paclitaxel+platinum+bevacizumab. Total cholesterol（TC），triglyceride（TG），high-density lipoprotein cholesterol（HDL-C），low-density lipoprotein cholesterol（LDL-C） and lipoprotein（a）[Lp（a）] determination results were collected before treatment and 2 d after chemotherapy in the 2 groups. The follow-up endpoint was defined as the occurrence of tumor progression，and the progression-free survival（PFS） was recorded. The differences in PFS in patients with ovarian epithelial cancer were assessed using Kaplan-Meier survival curve. The factors on PFS in patients with ovarian epithelial cancer were assessed using Cox proportional risk regression analysis. Results The differences in TC，TG，LDL-C，HDL-C and Lp（a） levels between paclitaxel+platinum group and paclitaxel+platinum+bevacizumab group before treatment had no statistical significance（P>0.05）. The differences in TC，TG，LDL-C，HDL-C and Lp（a） levels before and after treatment in paclitaxel+platinum group were also not statistically significant（P>0.05）. The levels of TC and TG were higher in paclitaxel+platinum+bevacizumab group after treatment than those before treatment（P<0.05），while the differences in the levels of LDL-C，HDL-C and Lp（a） were not statistically significant before and after treatment（P>0.05）. The bevacizumab group was classified into 2 subgroups based on whether TC and/or TG were increased（bevacizumab lipid increased group and bevacizumablipid non-increased group）. The progression-free survival rate was sequentially higher inpaclitaxel+platinumgroup，bevacizumab lipid increased groupandbevacizumablipid non-increased group（Log-rank χ²=17.98，P<0.001）. The International Federation of Gynecology and Obstetrics（FIGO） stage Ⅲ-Ⅳ and increased TC and TG after treatment were independent risk factors for shorter PFS in bevacizumab group [hazard ratios（HR） were 2.53，1.89 and 1.32，95% confidence intervals（CI） were 1.85-4.52，1.05-2.82 and 1.11-3.01，respectively]. Conclusions Bevacizumab may benefit patients with ovarian epithelial cancer，but its treatment may lead to increased TC and TG levels with shortened PFS in some patients，which should be of clinical concern.

Key words: Total cholesterol, Triglyceride, Bevacizumab, Ovarian epithelial cancer