Prognostic role of pre-diagnostic circulating inflammatory biomarkers in breast cancer survival: evidence from the EPIC cohort study

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2024年9月28日

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Carlota Castro-Espin,
Manon Cairat,
Anne-Sophie Navionis,
Christina C. Dahm,
Christian S. Antoniussen,
Anne Tjønneland,
Lene Mellemkjær,
Francesca Romana Mancini,
Mariem Hajji-Louati,
Gianluca Severi,
Charlotte Le Cornet,
Rudolf Kaaks,
Matthias B. Schulze,
Giovanna Masala,
Claudia Agnoli,
Carlotta Sacerdote,
Marta Crous-Bou,
Maria-Jose Sánchez,
Pilar Amiano,
María-Dolores Chirlaque,
Marcela Guevara,
Karl Smith-Byrne,
Alicia K. Heath,
Sofia Christakoudi,
Marc J. Gunter,
Sabina Rinaldi,
Antonio Agudo,
Laure Dossus

摘要

Background

Inflammation influences tumour progression and cancer prognosis, but its role preceding breast cancer (BC) and its prognostic implications remain inconclusive.

Methods

We studied pre-diagnostic plasma inflammatory biomarkers in 1538 women with BC from the EPIC study. Cox proportional hazards models assessed their relationship with all-cause and BC-specific mortality, adjusting for tumour characteristics and lifestyle factors.

Results

Over a 7-year follow-up after diagnosis, 229 women died, 163 from BC. Elevated IL-6 levels were associated with increased all-cause mortality risk (HR_1-SD 1.25, 95% CI 1.07–1.47). Among postmenopausal, IL-6 was associated with higher all-cause (HR_1-SD 1.41, 95% CI 1.18–1.69) and BC-specific mortality (HR_1-SD 1.31, 95% CI 1.03–1.66), (P_{Heterogeneity (pre/postmenopausal)} < 0.05 for both), while IL-10 and TNFα were associated with all-cause mortality only (HR_1-SD 1.19, 95% CI 1.02–1.40 and HR_1-SD 1.28, 95% CI 1.06–1.56). Among ER+PR+, IL-10 was associated with all-cause and BC-specific mortality (HR_1-SD 1.35, 95% CI 1.10–1.65 and HR_1-SD 1.42 95% CI 1.08–1.86), while TNF-α was associated with all-cause mortality in HER2- (HR_1-SD 1.31, 95% CI 1.07–1.61). An inflammatory score predicted higher all-cause mortality, especially in postmenopausal women (HR_1-SD 1.30, 95% CI 1.07–1.58).

Conclusions

Higher pre-diagnosis IL-6 levels suggest poorer long-term survival among BC survivors. In postmenopausal survivors, elevated IL-6, IL-10, and TNFα and inflammatory scores seem to predict all-cause mortality.