Correlation between Serum Interleukin-6 Levels and Clinical Response to Anthracycline-Based Neoadjuvant Chemotherapy Regimen in Locally Advanced Breast Cancer Patients

Abstract

Background: Neoadjuvant chemotherapy is the initial therapy and the main pillar of treatment for locally advanced breast cancer (LABC). Currently, there is marker that widely accepted as a predictive factor for chemotherapy response in LABC. Elevated serum interleukin-6 (IL-6) levels and tumor sites have been proposed as prognostic markers for breast cancer. In this study, we aimed to examine the association between serum IL-6 levels with clinical response after the administration of neoadjuvant chemotherapy. Methods: This study is an observational analytic study with a cohort prospective character to determine the relationship between IL-6 serum levels and clinical response to anthracycline-based neoadjuvant chemotherapy in locally advanced breast cancer (LABC) patients at Dr. Soetomo General Hospital during April 2021 to September 2021 with a total sample of 38 patients. Results: Fourteen patients (77.8%) had a positive response in the low IL-6 level group and 4 patients (22.2%) had a negative response. In high IL-6 level group, 4 patients (40%) had a positive response and 16 patients (80%) had a negative response. The cut off of 15.495 pg/mL was used as cut off value for IL-6 to predict the clinical response to chemotherapy. The sensitivity, specificity, PPV, NPV, and accuracy of IL-6 to predict the clinical response after chemotherapy were 80.0%, 77.8%, 80.0%, 77.8%, and 78.9%, respectively. Conclusion: There is a relationship between serum IL-6 levels and clinical response to anthracycline-based neoadjuvant chemotherapy regimens in locally advanced breast cancer (LABC) patients. Keywords: interleukin-6, clinical response, locally advanced breast cancer.

Interleukin-6 serum levels in metastatic breast cancer and non-metastatic breast cancer

“…In this study, a cut-off point of IL-6 serum levels in the non-MBC and MBC groups was obtained based on the previous study. Pratama et al (Pratama et al, 2021) suggested that the limit value for IL-6 serum levels to detect the possibility of metastases was >15.495 pg/mL. From the analysis of this study, it was found that there was a statistically significant relationship between IL-6 serum levels and the incidence of metastasis (P = 0.001).…”

“…Previous research by Pratama (2021), showed that IL-6 levels above 15,495 pg/ml were associated with increased severity of breast cancer, characterized by a worsening of the cancer response to chemotherapy. (Pratama, 2021) At the moment, there are no biological factors from the tumor that can be used clinically as acceptable predictive factors of distant metastases in breast cancer. Therefore, in this study we aimed to measure serum IL-6 levels which play an important role in the pathogenesis of the metastatic process of non-MBC patients compared to MBC, to assess whether serum IL-6 levels can be alternative as a marker of tumor progression.…”

“…It plays a role in angiogenesis and cell adhesion in malignancy. Hence, it will increase the chance of tumor metastases (Pratama, 2021). Previous research by Pratama (2021), showed that IL-6 levels above 15,495 pg/ml were associated with increased severity of breast cancer, characterized by a worsening of the cancer response to chemotherapy.…”

“…Hence, it will increase the chance of tumor metastases (Pratama, 2021). Previous research by Pratama (2021), showed that IL-6 levels above 15,495 pg/ml were associated with increased severity of breast cancer, characterized by a worsening of the cancer response to chemotherapy. (Pratama, 2021) At the moment, there are no biological factors from the tumor that can be used clinically as acceptable predictive factors of distant metastases in breast cancer.…”