Prognosis value of cytokine levels in response to chemotherapy in non small cell lung cancer

BA Alvarez PhD, MR Alemán Valls MD a, M Llanos Muñoz MD b, J Oramas Rodríguez MD c, , J Cruz Jurado MD d, L Rodríguez Rodríguez PhD e, A Martínez Riera MD f, E González Reimers MD g, F Santolaria Fernández MD h, Batista López MD i.

1Department of Internal Medicine, Service of Oncolgy Medicine and Department of Medicine, Service Internal Medicine 2Hospital Universitario de Canarias. Tenerife. Spain.

Aim: Cytokines have a prognosis value in survival of non small cell lung cancer (NSCLC) at advanced stage. Our objective is to study if cytokine levels depends on chemotherapy, and if the initial concentration of them is related with tumor response to chemotherapy. Methods: We determined serum levels: IL 6, IFN (g) γ , sIL2R, C reactive protein (CRP) and ferritin in 75 patients diagnosed non surgical NSCLC before chemotherapy, and in 54 of them after 3 cycles of chemotherapy. Results: Median survival was 199 ± 9 days. Kaplan-Meyer analysis showed that patients with NSCLC and higher levels of IL-6 and sIL2R had poor survival that patients with lower levels; whereas patients with high levels of IFN (g) γ , had a better survival than patients with low levels. After chemotherapy, we selected patients according to treatment response: stable disease, partial response and progression tumor. IL-6 levels increased in patients with tumor progression, respect to the other two groups in which this levels slightly decreased (p=0,024); CRP levels had a similar response (p=0,041). Also sIL2R had a important increase in patients with tumor progression and a slight increase in the other two groups (p=0,028). Serum ferritin had a significant increased without differences between the three groups (p=0,000). Nevertheless, IFN (g) γ levels had a significant decrease after chemotherapy in the three groups (p=0,000). We did not found any relationship between initial values of citokynes and treatment response. Conclusion: These results demonstrate that although citokynes are related with survival in NSCLC advanced stage, and some of them change in relation to treatment response, their initial values do not predict tumor response to chemotherapy.

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Paper presented at the International Symposium on Predictive Oncology and Intervention Strategies; Paris, France; February 9 - 12, 2002; in the section on Predictive Markers.