The relationship between the insulin-like growth factor-1 axis, weight loss, an inflammation-based score and survival in patients with inoperable non-small cell lung cancer

Abstract

Methods: 56 patients with inoperable NSCLC were studied. The plasma concentrations of IGF-1, IGFBP-3 and leptin were measured using ELISA and RIA. Results:The patients were predominantly male (61%), over 60 years old (80%), with advanced (stage III or IV) disease (98%), with a BMI >20 (84%), an ECOG-ps of 0 or 1 (79%), a haemoglobin (59%) and white cell count (79%) in the reference range. On followup 43 patients died of their cancer. On univariate analysis, BMI (p<0.05), Stage (p<0.05), ECOG-ps (p<0.05), haemoglobin (p<0.05), white cell count (p<0.05) and mGPS (p<0.05)were associated with cancer specific survival. There was no association between age, sex, treatment, IGF-1, IGFBP-3, IGF-1:IGFBP-3 ratio, or leptin and cancer specific survival.With an increasing mGPS concentrations of haemoglobin (p<0.005) and decreased. mGPS was not associated with either IGF-1(p>0.20), or leptin (p>0.20). Conclusions:In summary, the results of this study suggest that anabolism (IGF-1 axis) does not play a significant role in the relationship between nutritional and functional decline, systemic inflammation and poor survival in patients with inoperable NSCLC.

Baseline Insulin-Like Growth Factor-I Plasma Levels, Systemic Inflammation, Weight Loss and Clinical Outcome in Metastatic Non-Small Cell Lung Cancer Patients

“…In the same study, when correlated with clinicopathologic features, no statistically significant differences were found for IGF-I levels according to gender, smoking status, PS, stage and histologic subtype. However, most recent data from 56 inoperable NSCLC patients did not confirm the previous report as there was no association between IGF-I and cancer-specific survival, suggesting that IGF-I may not play a significant role in the relationship between nutritional and functional decline, systemic inflammation and poor survival in these patients [15]. …”

“…IGF-I failed to retain its importance in the multivariate model probably due to its previously described correlation with PS. In the literature, two other studies addressed the prognostic role of IGF-I with conflicting results [14,15]. However, even in the positive study of Han et al [14], in which IGF-I emerged as an independent determinant of both progression-free survival and OS, the HRs suggest that the predictive value of IGF-I may be greater than its prognostic significance.…”

Modified glasgow prognostic score in patients with small-cell lung cancer

“…In patients with cancer, a systemic inflammatory response leads to increased protein breakdown and progressive nutritional decline by a direct catabolic effect on skeletal muscle and other host tissue (1)(2)(3)(4). Such progressive nutritional decline leads to poorer survival (1)(2)(3)(4).…”

“…Such progressive nutritional decline leads to poorer survival (1)(2)(3)(4). The measurement of the systemic inflammatory response has been subsequently refined using a selective combination of serum albumin and C-reactive protein (CRP) (termed the modified Glasgow Prognostic Score, mGPS) and has been revealed to have prognostic value, independent of tumor stage, in non-small cell lung, gastrointestinal and renal cancer (5,6).…”

Elevated expression of CXCR4 and correlation with clinicopathological features and prognosis of non-small cell lung cancer patients: a meta-analysis

“…According to the criterion of histology, NSCLC can be further classified into several types, such as large cell carcinoma, adenocarcinoma, and squamous cell carcinoma; the two major histological subtypes of NSCLC are adenocarcinoma and squamous cell carcinoma (Tran, 2013;Ao et al, 2014). An estimated 30,000 new NSCLC cases are being diagnosed yearly in the United Kingdom (Meek et al, 2010). Chiefly, because of the silent symptoms of NSCLC during its early stages, and tendency to metastasize during its latter stages, curative resection is only implemented in 25-30% of the patients diagnosed with NSCLC (Jafri et al, 2013;Remon et al, 2013).…”