Associations of inflammation with frailty in patients with breast cancer aged 50 and over receiving chemotherapy. Issue 3 (April 2020)

• Record Type: Journal Article
• Authors: Gilmore, Nikesha; Kadambi, Sindhuja; Lei, Lianlian; Loh, Kah Poh; Mohamed, Mostafa; Magnuson, Allison; Cole, Sharon; Esparaz, Benjamin T.; Giguere, Jeffrey K.; Mohile, Supriya; Janelsins, Michelle
• Is Part Of: Journal of geriatric oncology. Volume 11:Issue 3(2020)
• Page Start: 423
• Page End: 430
• Publication Date: 2020-04
• Subjects: Frailty -- Chemotherapy -- Inflammation -- Breast cancer -- Cytokines -- Receptors; Geriatric oncology -- Periodicals; Neoplasms -- Periodicals; Aged -- Periodicals; Geriatric oncology; Electronic journals; Periodicals; 618.976994005
• DOI: 10.1016/j.jgo.2019.04.001
• Languages: English
• ISSNs: 1879-4068

Abstract

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.