title: Predictive and prognostic value of LPS-stimulated cytokine secretion in metastatic non-small cell lung cancer.
abstract: OBJECTIVE
  Cancer patients usually develop malnutrition which may alter their innate immune system integrity. The aim of this study was to investigate the clinical relevance of chemokine response after lipopolysaccharide (LPS)-stimulation in metastatic non-small cell lung cancer (NSCLC).
  
  
  METHODS
  Blood samples from metastatic NSCLC patients were incubated with LPS before the onset of systemic therapy. Interleukin (IL)-6 and IL-8 levels at baseline and after LPS-stimulation were measured and the fold change compared to baseline levels was evaluated as the stimulation index for each cytokine per patient. Results were correlated with sex, age, smoking status, histologic subtype, performance status (PS), albumin, Mini Nutritional Assessment (MNA) status and clinical outcomes.
  
  
  RESULTS
  Totally 103 patients were evaluated. Mean (±SD) stimulation index was 37.6 (±57.8) for IL-6 and 76.7 (±133.4) for IL-8. The disease control rate after first-line chemotherapy was 44/80 (55 %) and the mean (±SD) progression-free survival (PFS) and overall survival (OS) were 4.2 (±3.9) and 9.2 (±1.1) months, respectively. MNA, PS, albumin, IL-6 and IL-8 stimulation indices were univariately associated with PFS and OS. IL-8 stimulation index emerged as an independent predictor of both PFS and OS, along with PS, and albumin levels.
  
  
  CONCLUSIONS
  The extent of IL-6 and IL-8 stimulation after ex vivo induction with LPS is an important predictor of clinical outcome in metastatic NSCLC patients.
authors: Department of Medical Oncology, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, Biopolis, Larissa, 41110, Greece, pvlacho@med.uth.gr.
authors: P J
authors: PJ
authors: Vlachostergios
authors: I
authors: I
authors: Gioulbasanis
authors: S
authors: S
authors: Ghosh
authors: C
authors: C
authors: Tsatsanis
authors: G
authors: G
authors: Papatsibas
authors: A
authors: A
authors: Xyrafas
authors: E
authors: E
authors: Hatzidaki
authors: C
authors: C
authors: Vasiliou
authors: K
authors: K
authors: Kamposioras
authors: S
authors: S
authors: Agelaki
authors: A N
authors: AN
authors: Margioris
authors: D
authors: D
authors: Nasi
authors: V
authors: V
authors: Georgoulias
authors: C N
authors: CN
authors: Papandreou
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy / Q000556:secondary; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood* / Q000188:drug therapy / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000188:drug therapy / Q000556:secondary; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007239:Infections / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D015850:Interleukin-6 / Q000097:blood*; D016209:Interleukin-8 / Q000097:blood*; D008070:Lipopolysaccharides / Q000494:pharmacology*; D008175:Lung Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009752:Nutritional Status; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D015850:Interleukin-6; D016209:Interleukin-8; D008070:Lipopolysaccharides