title: Effect of standard anthracycline based neoadjuvant chemotherapy on circulating levels of serum IL-6 in patients of locally advanced carcinoma breast - a prospective study.
abstract: BACKGROUND
  Elevated IL-6 levels have been associated with advanced stage of breast cancer and metastasis-related morbidity. The present prospective study was carried out to assess the effect of neoadjuvant chemotherapy on circulating levels of serum IL-6 in patients of locally advanced carcinoma breast.
  
  
  METHODS
  All locally advanced carcinoma breast cases presenting to the surgery out patient's department were included in the study excluding pregnant or lactating females and those patients who were unfit for anthracycline based chemotherapy. A total of 30 cases were included. The various parameters that were evaluated include detailed clinico-pathological profile and IL-6 levels. Clinical staging using TNM classification was performed in all enrolled patients. This included documenting tumor size (on USG), node status and metastatic workup. First blood sample was collected before start of any treatment. Second blood sample was collected after 3 cycles of chemotherapy. Blood was centrifuged within 30 min and serum kept at -80 °C until analysis for IL-6. IL-6 levels were quantified by ELISA.
  
  
  RESULTS
  Majority of patients presented in stage T3N1M0 (66.66%). The serum level of IL-6 increased as the disease progressed from T3N1M0 to T4dN2M0 (41.4 ± 31.9 pg/ml vs. 164.0 ± 31.1 pg/ml respectively). A progressive reduction in IL-6 levels with subsequent cycles of chemotherapy was observed which was statistically significant (from 72.8 ± 56.0 pg/ml to 47.0 ± 61.9 pg/ml; p value 0.002 wilcoxan signed rank test).
  
  
  CONCLUSIONS
  Our study shows a consistent decline in the IL-6 levels with chemotherapy. Upon ratification of our findings by large population based multi centric studies, we may state with conviction that a single blood test as serum level of IL6 will prove beneficial in assessing the efficacy of chemotherapy.
authors.affiliation: Department of Surgery, Lady Hardinge Medical College, Delhi, India. nikhil_ms26@yahoo.co.in
authors.forename: Nikhil
authors.initials: N
authors.lastname: Gupta
authors.forename: Binita
authors.initials: B
authors.lastname: Goswami
authors.forename: Pankaj
authors.initials: P
authors.lastname: Mittal
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D018943:Anthracyclines; D015850:Interleukin-6