Effect of Silymarin in Metastatic Colorectal Cancer Patients

this work is aim to assess the antitumor effect of silymarin in patients with metastatic colorectal cancer receiving chemotherapy with or without target therapy (Bevacizumab).

Inclusion Criteria:- Patients with histologically and/or radiologically confirmed diagnosis of metastatic colorectal carcinoma.Patients who received FOLFOX or XELOX as first line chemotherapyBoth genders.Age ≥18 years old.Performance status 0-1 according to the Eastern Cooperative Oncology Group (ECOG).Patients with adequate hematologic parameters (white blood cell count≥3000/mm3, granulocytes ≥1500/mm3, platelets ≥100,000/mm3, hemoglobin ≥ 8 gm/l).Patients with adequate renal functions (serum creatinine ≤1.5 mg/dL).Patients with adequate hepatic functions (bilirubin ≤1.5 mg/dL or albumin ≥3 g/dL).Exclusion Criteria:- Patients with active liver diseases (chronic viral hepatitis, autoimmune hepatitis, alcoholic hepatitis, Wilson's disease, hemochromatosis, or cirrhosis).Patients with a history of other malignancy.Patients with brain metastasis.Patients with active infection.Patients with RAS wild type cancer.Patients on chronic use of corticosteroids.