Resident University of Texas Southwestern Medical Center Dallas, Texas, United States
Disclosure: Disclosure information not submitted.
Participants should be aware of the following financial/non-financial relationships:
John D. Karalis, MD: Disclosure information not submitted.
Introduction: There are few prognostic biomarkers for gastric and gastroesophageal junction adenocarcinoma (G+GEJ). The systemic inflammatory response of G+GEJ patients has been associated with survival. Circulating serum cytokine levels are reflective of the inflammatory state of patients. In this study, we evaluated the relationship between circulating serum cytokine levels and overall survival (OS) in G+GEJ patients.
Methods: A retrospective review of a prospectively maintained biobank was performed to identify patients diagnosed with G+GEJ from 2016-2019. Clinicopathologic factors and outcome status were recorded. Pre-treatment serum was collected at the time of diagnosis. For patients who underwent neoadjuvant treatment, a serum sample was collected immediately prior to surgical resection. The serum level of 17 cytokines was assayed using the Bio-Plex Pro Human Cytokine 17-plex Assay (Bio-Rad Laboratories, Hercules, CA). A multivariable Cox regression model was used to assess the association of cytokine concentration with OS. The Wilcoxon signed-rank test was used to compare the serum cytokine level of pre-treatment and post-neoadjuvant treatment samples.
Results: The study cohort was comprised of 64 patients. 29 patients had locally advanced tumors (T3/T4 or N+) and 35 patients had metastases. On multivariable analysis only clinical stage and IL-6 level independently associated with OS. Patients in the top tertile of pre-treatment IL-6 level had worse OS than patients in the bottom tertile (HR: 2.91; 95% CI: 1.18-7.22; p < 0.05). In patients who underwent neoadjuvant therapy (n = 29), the IL-6 level did not change after treatment.
Conclusions: Pre-treatment serum level of IL-6 is a promising prognostic biomarker for patients with G+GEJ.
Learning Objectives:
Upon completion, participant will be able to describe the association of cytokine markers of inflammation with gastric cancer prognosis.
Upon completion, participant will consider the potential of IL-6 as a prognostic biomarker in gastric cancer.
Upon completion, participant will consider the need for improved pre-treatment biomarkers in gastric cancer.