JCO: Pre-chemotherapy inflammatory markers are associated with worsening of clinical symptoms caused by chemotherapy in elderly breast cancer patients

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J Clin Oncol: Inflammatory markers evaluated before adjuvant chemotherapy are associated with worsening of clinical symptoms due to chemotherapy in elderly breast cancer patients

▎Clinical Questions: Elderly
breast cancer (BC) survivors have an increased risk of worsening clinical symptoms after adjuvant chemotherapy, but it is unclear
whether inflammatory markers assessed before adjuvant chemotherapy are associated with worsening clinical symptoms caused by chemotherapy in elderly BC patients.

The results of a study from J Clin Oncol suggest that pre-chemotherapy high interleukin-6 (IL-6) and C-reactive protein (CRP) are associated with a decrease in debilitating states due to chemotherapy, independent of sociodemographic and clinical risk factors
.


▎ Study Protocol:
In a prospective study of women ≥ 65 years of age who received chemotherapy in patients with stage III BC, researchers tested IL-6 and CRP
before chemotherapy (T1).
Investigators used the Deficit Accumulation Index (DAI) after T1 and chemotherapy (T2; Divided into strong, fragile, and frail) to assess frail states
.
The group of people concerned is strong women
in T1 stage.
The main result is a decrease in a debilitating state due to chemotherapy, defined as a decrease in DAI from robust (T1) to pre-weakness or weakness (T2).

Multivariate logistic regression is used to study the relationship between inflammatory markers and primary prognosis and is adjusted
for sociodemographic and clinical characteristics.

▎ The main findings were:
(1) Among the 295 healthy women in stage T1, 76 cases (26%) experienced a decrease in debilitating state caused by chemotherapy, of which 66% of patients had elevated IL-6, 63% had high CRP, and 46% of patients had elevated
IL-6 and CRP in stage T1.

(2) After adjusting for sociodemographic and clinical features, women with high levels of IL-6 and CRP were more than three times more likely to have a decline in debilitating states than women with low levels of IL-6 and CRP (odds ratio = 3.
52; 95% CI, 1.
55-8.
01; P=0.
003) compared with women with low levels of IL-6 and CRP (odds ratio = 3.
52; 95% CI, 1.
55-8.
01; P=0.
003).


▎ Outlook:
In summary, in the cohort of elderly BC women with early BC who were clinically healthy before the start of chemotherapy, high IL-6 and CRP before chemotherapy were associated with a decrease in debilitating states due to chemotherapy, independent of sociodemographics and clinical risk factors
.
Further research is needed to examine whether inflammatory markers could provide a more personalized approach
to treating older BC survivors.

References:[1] https://ascopubs.
org/doi/full/10.
1200/JCO.
22.
01217
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