Alterations in inflammatory biomarkers and energy intake in cancer cachexia: a prospective study in patients with inoperable pancreatic cancer.
Chronic systemic inflammatory response is proposed as an underlying mechanism for development of cancer cachexia. We conducted a prospective study to examine changes in inflammatory biomarkers during the disease course and the relationship between inflammatory biomarkers and cachexia in patients with inoperable pancreatic cancer. Twenty patients, median (range) age 67.5 (35-79) years, 5 females, were followed for median 5.5 (1-12) months. Cachexia was diagnosed according to the 2011 consensus-based classification system (weight loss >5 % past six months, BMI < 20 kg/m(2) and weight loss >2 %, or sarcopenia) and the modified Glasgow Prognostic score (mGPS) that combines CRP and albumin levels. Inflammatory biomarkers were measured by enzyme immunoassays. The patients had increased levels of most inflammatory biomarkers, albeit not all statistically significant, both at study entry and close to death, indicating ongoing inflammation. According to the consensus-based classification system, eleven (55 %) patients were classified as cachectic upon inclusion. They did not differ from non-cachectic patients with regard to inflammatory biomarkers or energy intake. According to the mGPS, seven (35 %) were defined as cachectic and had a higher IL-6 (p < 0.001) than the non-cachectic patients. They also had a slightly, but insignificantly longer survival than non-cachectic patients (p = 0.08). The mGPS should be considered as an additional framework for identification of cancer cachexia.
Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Box 4, St. Olavs Plass, 0130, Oslo, Norway. asta.bye@hioa.no.|Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, Norway. asta.bye@hioa.no.
Asta
A
Bye
Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Box 4, St. Olavs Plass, 0130, Oslo, Norway.|Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Nima
N
Wesseltoft-Rao
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.|Department of Hematology, Oslo University Hospital, Oslo, Norway.
Per Ole
PO
Iversen
Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Box 4, St. Olavs Plass, 0130, Oslo, Norway.
Grete
G
Skjegstad
Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.|Norwegian National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
Kirsten B
KB
Holven
Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Box 4, St. Olavs Plass, 0130, Oslo, Norway.|Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
Stine
S
Ulven
Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, Norway.|European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Marianne J
MJ
Hjermstad
D000230:Adenocarcinoma / Q000097:blood / Q000378:metabolism / Q000473:pathology; D054392:Adipokines / Q000097:blood / Q000378:metabolism; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood / Q000378:metabolism*; D002100:Cachexia / Q000097:blood / Q000378:metabolism* / Q000473:pathology; D016022:Case-Control Studies; D016207:Cytokines / Q000097:blood / Q000378:metabolism; D002149:Energy Intake; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000378:metabolism / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000097:blood / Q000378:metabolism* / Q000473:pathology; D010865:Pilot Projects; D011446:Prospective Studies
D054392:Adipokines; D014408:Biomarkers, Tumor; D016207:Cytokines
Adipokines; Advanced cancer; Cancer cachexia; Cytokines; Inflammation; Pancreatic cancer