Acute and Chronic Effects of Adjuvant Therapy on Inflammatory Markers in Breast Cancer Patients

Julienne E Bower; Patricia A Ganz; Michael R Irwin; Steve W Cole; Judith Carroll; Kate R Kuhlman; Laura Petersen; Deborah Garet; Arash Asher; Sara A Hurvitz; Catherine M Crespi

doi:10.1093/jncics/pkac052

Acute and Chronic Effects of Adjuvant Therapy on Inflammatory Markers in Breast Cancer Patients

JNCI Cancer Spectr. 2022 Jul 1;6(4):pkac052. doi: 10.1093/jncics/pkac052.

Authors

Julienne E Bower^{1

2

3

4}, Patricia A Ganz^{4

5}, Michael R Irwin^{2

3}, Steve W Cole^{2

3

6}, Judith Carroll^{2

3}, Kate R Kuhlman^{3

7}, Laura Petersen⁴, Deborah Garet³, Arash Asher⁸, Sara A Hurvitz^{4

6}, Catherine M Crespi^{4

9}

Affiliations

¹ Department of Psychology, University of California, Los Angeles, CA, USA.
² Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
³ Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
⁴ Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA.
⁵ Schools of Medicine and Public Health, University of California, Los Angeles, CA, USA.
⁶ Department of Medicine, University of California, Los Angeles, CA, USA.
⁷ Department of Psychological Science of California, University of California, Irvine, CA, USA.
⁸ Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, USA.
⁹ Department of Biostatistics, University of California, Los Angeles, CA, USA.

Abstract

Background: Inflammation contributes to poor behavioral, functional, and clinical outcomes in cancer survivors. We examined whether standard cancer treatments-radiation and chemotherapy-led to acute and persistent changes in circulating markers of inflammation in breast cancer patients.

Methods: A total of 192 women diagnosed with early stage breast cancer provided blood samples before and after completion of radiation and/or chemotherapy and at 6-, 12-, and 18-month posttreatment follow-ups. Samples were assayed for circulating inflammatory markers, including tumor necrosis factor-α (TNF-α) and interleukin (IL)-6, downstream markers of their activity (soluble TNF receptor type II [sTNF-RII], C reactive protein), and other inflammatory mediators (IL-8, interferon-γ [IFN-γ]). Analyses evaluated within-group changes in inflammatory markers in 4 treatment groups: no radiation or chemotherapy (n = 39), radiation only (n = 77), chemotherapy only (n = 18), and chemotherapy with radiation (n = 58).

Results: Patients treated with chemotherapy showed statistically significant increases in circulating concentrations of TNF-α, sTNF-RII, IL-6, and IFN-γ from pre- to posttreatment, with parameter estimates in standard deviation units ranging from 0.55 to 1.20. Those who received chemotherapy with radiation also showed statistically significant increases in IL-8 over this period. Statistically significant increases in TNF-α, sTNF-RII, IL-6, IFN-γ, and IL-8 persisted at 6, 12, and 18 months posttreatment among patients treated with chemotherapy and radiation (all P < .05). Patients treated with radiation only showed a statistically significant increase in IL-8 at 18 months posttreatment; no increases in any markers were observed in patients treated with surgery only.

Conclusions: Chemotherapy is associated with acute increases in systemic inflammation that persist for months after treatment completion in patients who also receive radiation therapy. These increases may contribute to common behavioral symptoms and other comorbidities in cancer survivors.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Biomarkers
Female
Humans
Inflammation
Inflammatory Breast Neoplasms*
Interferon-gamma
Interleukin-6
Interleukin-8
Receptors, Tumor Necrosis Factor*
Tumor Necrosis Factor-alpha

Substances

Biomarkers
Interleukin-6
Interleukin-8
Receptors, Tumor Necrosis Factor
Tumor Necrosis Factor-alpha
Interferon-gamma

Abstract

Publication types

MeSH terms

Substances

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