Pre-treatment levels of inflammatory markers and chemotherapy completion rates in patients with early-stage breast cancer

Tim Schauer*, Anna Henriksson, Emelie Strandberg, Henrik Lindman, Sveinung Berntsen, Ingrid Demmelmaier, Truls Raastad, Karin Nordin, Jesper F. Christensen


Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review


Background: Chemotherapy efficacy is largely dependent on treatment adherence, defined by the relative dose intensity (RDI). Identification of new modifiable risk factors associated with low RDI might improve chemotherapy delivery. Here, we evaluated the association between low RDI and pre-chemotherapy factors, including patient- and treatment-related characteristics and markers of inflammation. Methods: This exploratory analysis assessed data from 267 patients with early-stage breast cancer scheduled to undergo (neo-)adjuvant chemotherapy included in the Physical training and Cancer (Phys-Can) trial. The association between low RDI, defined as < 85%, patient-related (age, body mass index, co-morbid condition, body surface area) and treatment-related factors (cancer stage, receptor status, chemotherapy duration, chemotherapy dose, granulocyte colony-stimulating factor) was investigated. Analyses further included the association between RDI and pre-chemotherapy levels of interleukin (IL)-6, IL-8, IL-10, C-reactive protein (CRP) and Tumor Necrosis Factor-alpha (TNF-α) in 172 patients with available blood samples. Results: An RDI of < 85% occurred in 31 patients (12%). Univariable analysis revealed a significant association with a chemotherapy duration above 20 weeks (p < 0.001), chemotherapy dose (p = 0.006), pre-chemotherapy IL-8 (OR 1.61; 95% CI (1.01; 2.58); p = 0.040) and TNF-α (OR 2.2 (1.17; 4.53); p = 0.019). In multivariable analyses, inflammatory cytokines were significant association with low RDI for IL-8 (OR: 1.65 [0.99; 2.69]; p = 0.044) and TNF-α (OR 2.95 [1.41; 7.19]; p = 0.007). Conclusions: This exploratory analysis highlights the association of pre-chemotherapy IL-8 and TNF-α with low RDI of chemotherapy for breast cancer. IL-8 and TNF-α may therefore potentially help to identify patients at risk for experiencing dose reductions. Clinical trial number NCT02473003 (registration: June 16, 2015).

TidsskriftInternational Journal of Clinical Oncology
Udgave nummer1
Sider (fra-til)89-98
StatusUdgivet - jan. 2023

Bibliografisk note

Funding Information:
The study was supported by the (World Cancer Research Fund International), Wereld Kanker Onderzoek Fonds, (IIG_2016_1635), The Swedish Cancer Society (150841, 160483); The Swedish Research Council (KDB/9514); The Nordic Cancer Union (2015), and The Oncology Department Foundations Research Fund in Uppsala (2016, 2017). The Centre for Physical Activity Research (CFAS) is supported by TrygFonden (ID 101390 and ID 20045). The study was further supported by grants from the Lundbeck Foundation.

Publisher Copyright:
© 2022, The Author(s) under exclusive licence to Japan Society of Clinical Oncology.


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