Increased pre-chemotherapy inflammatory biomarkers (IL-6 and CRP) correlated to increased risk of frailty post-chemotherapy in older breast cancer patients

1. 25.8% of patients who received chemotherapy for breast cancer experienced worsening frailty status.

2. Patients with both biomarkers (IL-6 and CRP) elevated prior to chemotherapy had a significantly higher risk of worsening frailty status.

Evidence Rating Level: 2 (good)

Course of study: Interleukin-6 (IL-6) and C-reactive protein (CRP) are two inflammatory biomarkers that have been linked to worsening post-chemotherapy frailty in elderly patients who have been diagnosed and treated for breast cancer. This study examined whether there was a deterioration from baseline in frailty status in patients with breast cancer after adjuvant chemotherapy, consistent with inflammatory biomarkers. Median cutoff levels were chosen based on previous studies and IL-6 was 2.5 pg/mL and CRP was 3.5 mg/L. The primary outcome of this study was whether there was a decrease in frailty status after chemotherapy as measured by a Deficit Accumulation Index (DAI). When evaluating baseline characteristics, it was found that BMI or anti-inflammatory drug use were not associated with inflammatory biomarkers (IL-6 and CRP). There was evidence of worsening frailty status in 25.8% of women following chemotherapy treatment for their breast cancer. Patients who became more frail had significantly higher baseline levels of inflammatory biomarkers IL-6 and CRP. Limitations of this study include the short follow-up period, making it difficult to draw conclusions on long-term recovery of frailty status. In addition, the study did not account for events that may have occurred during treatment, including hospitalizations or severe treatment-related toxicity. Overall, the results of this study demonstrate that high baseline levels of the inflammatory biomarkers IL-6 and CRP are associated with increased frailty due to chemotherapy following breast cancer treatment.

Also Read :  Newly Discovered Protein Connected to Significant Increase in Risk of Alzheimer’s Disease

Click here to read the study in the Journal of Clinical Oncology

Relevant reading: Interleukin-6 and C-reactive protein, successful aging and mortality: The PolSenior study.

Detailed [prospective cohort]: This prospective cohort study was conducted at 16 health centers in the United States. The study enrolled adult patients aged 65 years and older who had been diagnosed and treated with stage I, II or III breast cancer. The final study cohort consisted of 295 patients, of whom 37.3% had stage I cancer and 62.7% had stage II or III cancer. Before chemotherapy, 82% of patients underwent breast cancer surgery (48% underwent mastectomy and 52% underwent lumpectomy). Patients with higher baseline levels of IL-6 (median 3.57 pg/mL) experienced a decrease in their frailty status after receiving chemotherapy compared to patients who did not experience a decrease (median 2.15 pg/mL). The result was similar for baseline CRP levels (median 4.75 mg/L versus 3.06 mg/L). The majority of the 76 patients who experienced worsening of their frailty status after chemotherapy had high biomarker values; 63.2% had high CRP, 65.8% had high IL-6, and nearly half (46.1%) had high levels of both biomarkers. Chemotherapy-induced frailty was 2.2 times more likely in patients with high IL-6 (odds ratio (OR), 2.21; 95% confidence interval (CI), 1.28-3.80) and 2.1 times more likely in patients with high CRP (OR, 2.1; 95% CI, 1.23-3.62). Patients with elevated levels of both biomarkers had a more than 3-fold increased likelihood of post-chemotherapy frailty (OR, 3.61; 95% CI, 1.75-7.44). There was an overall clinically significant median change of 0.06 in DAI before and after chemotherapy. When compared to patients whose frailty status was unaffected, the DAI changed more in patients whose frailty status decreased (median change in DAI 0.12 vs. 0.03).

Also Read :  The Lord’s Day Reflection: “Mercy along the journey”

Image: PD

©2022 2 Minute Medicine, Inc. All rights reserved. No work may be reproduced without the express written consent of 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Also Read :  President Urges Social Media Influencers To Create Awareness On Breast Cancer