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

Author:

Bower Julienne E1234ORCID,Ganz Patricia A45,Irwin Michael R23,Cole Steve W236,Carroll Judith23,Kuhlman Kate R37,Petersen Laura4ORCID,Garet Deborah3,Asher Arash8,Hurvitz Sara A46,Crespi Catherine M49

Affiliation:

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

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.

Funder

National Cancer Institute at the National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Oncology

Reference38 articles.

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