Serum Interleukin 6 Level is Associated With Overall Survival and Treatment Response in Gastric and Gastroesophageal Junction Cancer.

Autor:	Karalis JD; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Ju MR; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Yoon LY; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Castro-Dubon EC; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Reznik SI; Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Hammer STG; Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX., Porembka MR; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX., Wang SC; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
Jazyk:	angličtina
Zdroj:	Annals of surgery [Ann Surg] 2023 Dec 01; Vol. 278 (6), pp. 918-924. Date of Electronic Publication: 2023 Jul 14.
DOI:	10.1097/SLA.0000000000005997
Abstrakt:	Objective: To identify novel prognostic and predictive biomarkers for gastric and gastroesophageal junction (G+GEJ) adenocarcinoma. Background: There are few biomarkers to guide treatment for G+GEJ. The systemic inflammatory response of G+GEJ patients is associated with survival. In this study, we evaluated the relationship of circulating serum cytokine levels with overall survival (OS) and pathologic tumor regression grade (TRG) in G+GEJ patients. Patients and Methods: We queried the UT Southwestern gastric cancer biobank to identify consecutive patients diagnosed with G+GEJ from 2016 to 2022; these patients had pretreatment serum collected at diagnosis. For patients who received neoadjuvant therapy, an additional serum sample was collected immediately before surgical resection. An unbiased screen of 17 cytokines was measured in a discovery cohort. A multivariable Cox proportional hazards model was used to assess the association of cytokine concentration with OS. Findings were validated in additional patients. In patients who received neoadjuvant therapy, we assessed whether the change in interleukin 6 (IL-6) after therapy was associated with TRG. Results: Sixty-seven patients were included in the discovery cohort, and IL-6 was the only pretreatment cytokine associated with OS; this was validated in 134 other patients (hazard ratio: 1.012 per 1 pg/mL increase, 95% CI: 1.006-1.019, P = 0.0002). Patients in the top tercile of IL-6 level had worse median OS (10.6 months) compared with patients in the intermediate (17.4 months) and bottom tercile (35.8 months, P < 0.0001). Among patients who underwent neoadjuvant therapy (n = 50), an unchanged or decrease in IL-6 level from pretreatment to posttreatment, had a sensitivity and specificity of 80% for predicting complete or near-complete pathologic tumor regression (TRG 0-1). Conclusions: Pretreatment serum level of IL-6 is a promising prognostic biomarker for G+GEJ patients. Comparing pre and post-neoadjuvant IL-6 levels may predict pathologic response to neoadjuvant therapy. Competing Interests: J.D.K. holds a Physician-Scientist Institutional Award from the Burroughs Wellcome Fund (Award no. 1018897). M.R.P. is a Dedman Family Scholar in Clinical Care. S.C.W. is a Disease Oriented Clinical Scholar at UT Southwestern. The authors report no conflicts of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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