Nikesha Gilmore1, Sindhuja Kadambi2, Lianlian Lei2, Kah Poh Loh2, Mostafa Mohamed2, Allison Magnuson2, Sharon Cole3, Benjamin T Esparaz4, Jeffrey K Giguere5, Supriya Mohile6, Michelle Janelsins7. 1. University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, United States of America. Electronic address: nikesha_gilmore@URMC.rochester.edu. 2. University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, United States of America. 3. Dayton Clinical Oncology Program, 3123 Research Blvd # 150, Dayton, OH 45420, United States of America; University of Rochester NCI Community Oncology Research Program, 265 Crittenden Blvd, Rochester, NY 14642, United States of America. 4. Heartland Cancer Research NCORP, 2300 North Edward Street Decatur, IL 62526, United States of America; University of Rochester NCI Community Oncology Research Program, 265 Crittenden Blvd, Rochester, NY 14642, United States of America. 5. NCORP of the Carolinas (Greenville Health System NCORP), 701 Grove Road, Greenville, SC 29605, United States of America; University of Rochester NCI Community Oncology Research Program, 265 Crittenden Blvd, Rochester, NY 14642, United States of America. 6. University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, United States of America; University of Rochester NCI Community Oncology Research Program, 265 Crittenden Blvd, Rochester, NY 14642, United States of America. 7. University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642, United States of America; University of Rochester NCI Community Oncology Research Program, 265 Crittenden Blvd, Rochester, NY 14642, United States of America. Electronic address: michelle_janelsins@URMC.rochester.edu.
Abstract
PURPOSE: Chronic inflammation is a significant physiologic feature of frailty; however, its role and clinical utility in cancer-related frailty remains unknown. We sought to determine if pre-chemotherapy inflammation is predictive of frailty after chemotherapy in patients with breast cancer. METHODS: Female patients (N = 144; age ≥ 50) with stage I-III breast cancer scheduled to receive chemotherapy and age-matched non-cancer controls (N = 142) were included in this secondary analysis and assessed pre- and post-chemotherapy. Controls were assessed at equivalent time-points. Frailty was assessed using a modified Fried's score (0-4) using self-reported measures of weakness, exhaustion, walking speed, and physical activity. Serum levels of interleukin (IL) 6, and soluble tumor necrosis factor-alpha (sTNFR) I and II were measured. Associations between pre-chemotherapy cytokine and receptors level (median as cutoff) and post-chemotherapy frailty were evaluated using t-tests. RESULTS: Pre-chemotherapy, patients with breast cancer were more frail than non-cancer controls (mean score: 1.17 vs 0.65; p < .01). Patients also became more frail post-chemotherapy (mean score: 1.17 vs 2.08; p < .01). Patients with pre-chemotherapy serum levels of IL-6, sTNFRI, and sTNFRII above the median were more frail after chemotherapy than those with levels below the median [IL-6 (2.31 vs. 1.86; p = .03), sTNFRI (2.30 vs. 1.88; p = .04), and sTNFRII (2.30 vs. 1.88; p = .04)]. No differences were observed in non-cancer controls within the same timeframe. CONCLUSIONS: Both cancer and chemotherapy were associated with frailty. Higher pre-chemotherapy inflammatory cytokine levels were associated with post-chemotherapy frailty. This supports the utility of inflammatory cytokines to identify patients who develop worsening of frailty characteristics with chemotherapy.
PURPOSE:Chronic inflammation is a significant physiologic feature of frailty; however, its role and clinical utility in cancer-related frailty remains unknown. We sought to determine if pre-chemotherapy inflammation is predictive of frailty after chemotherapy in patients with breast cancer. METHODS: Female patients (N = 144; age ≥ 50) with stage I-III breast cancer scheduled to receive chemotherapy and age-matched non-cancer controls (N = 142) were included in this secondary analysis and assessed pre- and post-chemotherapy. Controls were assessed at equivalent time-points. Frailty was assessed using a modified Fried's score (0-4) using self-reported measures of weakness, exhaustion, walking speed, and physical activity. Serum levels of interleukin (IL) 6, and soluble tumor necrosis factor-alpha (sTNFR) I and II were measured. Associations between pre-chemotherapy cytokine and receptors level (median as cutoff) and post-chemotherapy frailty were evaluated using t-tests. RESULTS: Pre-chemotherapy, patients with breast cancer were more frail than non-cancer controls (mean score: 1.17 vs 0.65; p < .01). Patients also became more frail post-chemotherapy (mean score: 1.17 vs 2.08; p < .01). Patients with pre-chemotherapy serum levels of IL-6, sTNFRI, and sTNFRII above the median were more frail after chemotherapy than those with levels below the median [IL-6 (2.31 vs. 1.86; p = .03), sTNFRI (2.30 vs. 1.88; p = .04), and sTNFRII (2.30 vs. 1.88; p = .04)]. No differences were observed in non-cancer controls within the same timeframe. CONCLUSIONS: Both cancer and chemotherapy were associated with frailty. Higher pre-chemotherapy inflammatory cytokine levels were associated with post-chemotherapy frailty. This supports the utility of inflammatory cytokines to identify patients who develop worsening of frailty characteristics with chemotherapy.
Authors: L P Fried; C M Tangen; J Walston; A B Newman; C Hirsch; J Gottdiener; T Seeman; R Tracy; W J Kop; G Burke; M A McBurnie Journal: J Gerontol A Biol Sci Med Sci Date: 2001-03 Impact factor: 6.053
Authors: Patricia A Ganz; J E Bower; L Kwan; S A Castellon; D H S Silverman; C Geist; E C Breen; M R Irwin; S W Cole Journal: Brain Behav Immun Date: 2012-08-03 Impact factor: 7.217
Authors: Barbara Brouwers; Sigrid Hatse; Lissandra Dal Lago; Patrick Neven; Peter Vuylsteke; Bruna Dalmasso; Guy Debrock; Heidi Van Den Bulck; Ann Smeets; Oliver Bechter; Jithendra Kini Bailur; Cindy Kenis; Annouschka Laenen; Patrick Schöffski; Graham Pawelec; Fabrice Journe; Ghanem-Elias Ghanem; Hans Wildiers Journal: Oncotarget Date: 2016-05-24
Authors: Yuan Yuan; Nilesh Vora; Can-Lan Sun; Daneng Li; David Smith; Joanne Mortimer; The-Hang Luu; George Somlo; James Waisman; Joseph Chao; Vani Katheria; Timothy Synold; Vivi Tran; Shu Mi; Tao Feng; Abrahm Levi; Anait Arsenyan; Jennifer Choi; Laura Zavala; Susan Yost; Arti Hurria Journal: Oncologist Date: 2017-05-30
Authors: Elizabeth K Belcher; Eva Culakova; Nikesha J Gilmore; Sara J Hardy; Amber S Kleckner; Ian R Kleckner; Lianlian Lei; Charles Heckler; Michael B Sohn; Bryan D Thompson; Louis T Lotta; Zachary A Werner; Jodi Geer; Judith O Hopkins; Steven W Corso; David Q Rich; Edwin van Wijngaarden; Michelle C Janelsins Journal: J Natl Cancer Inst Date: 2022-05-09 Impact factor: 11.816