Radiotherapy and radiochemotherapy increase serum levels of pro-inflammatory interleukin-6 and C-reactive protein in patients with head and neck cancers

Kiprian, Dorota; Czarkowska–Pączek, Bożena; Wyczalkowska-Tomasik, Aleksandra; Fuksiewicz, Małgorzata; Kotowicz, Beata; Pączek, Leszek

doi:10.21037/tcr.2017.12.23

Cited by 15 publications

(18 citation statements)

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“…We found a significant increase of IL-6 during chemoradiation that has already been described by other groups [ 48 , 49 ]. Both ionizing radiation and cisplatin have been shown to upregulate IL-6 expression in HNSCC in vitro and in vivo [ 50 ].…”

Section: Discussionsupporting

confidence: 88%

Interleukin-6 as surrogate marker for imaging-based hypoxia dynamics in patients with head-and-neck cancers undergoing definitive chemoradiation—results from a prospective pilot trial

Rühle

Wiedenmann

Fennell

et al. 2021

Eur J Nucl Med Mol Imaging

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Purpose Intratumoral hypoxia increases resistance of head-and-neck squamous cell carcinoma (HNSCC) to radiotherapy. [18F]FMISO PET imaging enables noninvasive hypoxia monitoring, though requiring complex logistical efforts. We investigated the role of plasma interleukin-6 (IL-6) as potential surrogate parameter for intratumoral hypoxia in HNSCC using [18F]FMISO PET/CT as reference. Methods Within a prospective trial, serial blood samples of 27 HNSCC patients undergoing definitive chemoradiation were collected to analyze plasma IL-6 levels. Intratumoral hypoxia was assessed in treatment weeks 0, 2, and 5 using [18F]FMISO PET/CT imaging. The association between PET-based hypoxia and IL-6 was examined using Pearson’s correlation and multiple regression analyses, and the diagnostic power of IL-6 for tumor hypoxia response prediction was determined with receiver-operating characteristic analyses. Results Mean IL-6 concentrations were 15.1, 19.6, and 31.0 pg/mL at baseline, week 2 and week 5, respectively. Smoking (p=0.050) and reduced performance status (p=0.011) resulted in higher IL-6 levels, whereas tumor (p=0.427) and nodal stages (p=0.334), tumor localization (p=0.439), and HPV status (p=0.294) had no influence. IL-6 levels strongly correlated with the intratumoral hypoxic subvolume during treatment (baseline: r=0.775, p<0.001; week 2: r=0.553, p=0.007; week 5: r=0.734, p<0.001). IL-6 levels in week 2 were higher in patients with absent early tumor hypoxia response (p=0.016) and predicted early hypoxia response (AUC=0.822, p=0.031). Increased IL-6 levels at week 5 resulted in a trend towards reduced progression-free survival (p=0.078) and overall survival (p=0.013). Conclusion Plasma IL-6 is a promising surrogate marker for tumor hypoxia dynamics in HNSCC patients and may facilitate hypoxia-directed personalized radiotherapy concepts. Trial registration The prospective trial was registered in the German Clinical Trial Register (DRKS00003830). Registered 20 August 2015

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Section: Discussionsupporting

confidence: 88%

Interleukin-6 as surrogate marker for imaging-based hypoxia dynamics in patients with head-and-neck cancers undergoing definitive chemoradiation—results from a prospective pilot trial

Rühle

Wiedenmann

Fennell

et al. 2021

Eur J Nucl Med Mol Imaging

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“…24,27 Of interest, in a series of 26 HNC patients, serum levels of pro-inflammatory markers, such as IL-6, were observed to increase after RT and chemo-radiotherapy. 27 Thereupon, paradoxically, oncological treatments may favor a tumor-promoting pro-inflammatory microenvironment. 27 Accordingly, Matsuoka et al 24 hypothesized improved outcomes, such as treatment response and survival, in oral squamous cell carcinoma patients, with the addition of tocilizumab to RT, given its capacity to limit the IL-6 effect in reducing radiation-induced DNA damage.…”

Section: An Cer and Il-6mentioning

confidence: 99%

“…26 The interplay between IL-6 and RT has been investigated in head and neck cancer (HNC). 24,27 Of interest, in a series of 26 HNC patients, serum levels of pro-inflammatory markers, such as IL-6, were observed to increase after RT and chemo-radiotherapy. 27 Thereupon, paradoxically, oncological treatments may favor a tumor-promoting pro-inflammatory microenvironment.…”

Section: An Cer and Il-6mentioning

confidence: 99%

A bond between rheumatic diseases and cancer in the elderly: The interleukin‐6 pathway

et al. 2021

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Interleukin (IL)-6 is a soluble factor secreted by T lymphocytes, involved in antibody generation by B lymphocytes. The IL-6 pathway has risen as a pivotal pathway implicated in immune regulation and dysregulation in various rheumatic diseases.Nonetheless, elevated IL-6 levels can also play a role in cancer. Targeting the IL-6 pathway has led to innovative therapeutic approaches for rheumatic diseases and for COVID-19, particularly in the elderly. Indeed, tocilizumab, an agent targeting IL-6, has recently amassed significant attention as a promising univocal agent for different conditions. In this viewpoint, we sought to recall and describe the common pathway among osteoarthritis, rheumatoid arthritis, and cancer, suggesting that anti-IL-6 may be considered a jack-of-all-trades against inflammaging in the elderly.

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“…Interestingly, in a series of 26 HNC patients, serum levels of proinflammatory markers, as IL-6, were found to be increased after RT and chemo-radiotherapy [11]. Thus, paradoxically, cancer treat-ments may favor a tumor-promoting pro-inflammatory microenvironment [11].…”

Section: Covid-19 Rapid Lettermentioning

confidence: 99%

The importance of IL-6 blockade beyond the COVID-19 pandemic: Consideration for cancer care

Iorio

Ricardi

Franco

2020

Radiotherapy and Oncology

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Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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Radiotherapy and radiochemotherapy increase serum levels of pro-inflammatory interleukin-6 and C-reactive protein in patients with head and neck cancers

Cited by 15 publications

References 0 publications

Interleukin-6 as surrogate marker for imaging-based hypoxia dynamics in patients with head-and-neck cancers undergoing definitive chemoradiation—results from a prospective pilot trial

Interleukin-6 as surrogate marker for imaging-based hypoxia dynamics in patients with head-and-neck cancers undergoing definitive chemoradiation—results from a prospective pilot trial

A bond between rheumatic diseases and cancer in the elderly: The interleukin‐6 pathway

The importance of IL-6 blockade beyond the COVID-19 pandemic: Consideration for cancer care

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