Association of interleukin-6 and tumor necrosis factor-? with mortality in hospitalized patients with cancer - 11/01/21
Abstract |
Background |
Severe cutaneous adverse reactions (SCARs) are associated with high morbidity and mortality in patients with cancer. Early identification and treatment of SCARs may improve outcomes.
Objective |
To identify biomarkers to predict outcomes in hospitalized patients with cancer who developed SCARs.
Methods |
Retrospective review of 144 hospitalized patients with cancer with a morbilliform rash, recorded testing for serum cytokines (interleukin [IL]-6, IL-10, and tumor necrosis factor [TNF]-α) or elafin, and a dermatology consultation. Rashes were categorized as simple morbilliform rash without systemic involvement or complex morbilliform rash with systemic involvement.
Results |
Fifty-four of 144 (37.5%) patients died during follow-up. Elevated levels of IL-6, IL-10, and TNF-α were associated with decreased survival. Overall survivals in patients with elevated levels of IL-6, IL-10, and TNF-α were 53.7%, 56.6%, 53.6%, respectively, compared with 85.7%, 82.5% and 83.6%, respectively, in those with lower levels. Patients with increased levels of both IL-6 and TNF-α had a nearly 6-fold increase in mortality (hazard ratio, 5.82) compared with patients with lower levels.
Limitations |
Retrospective design, limited sample size, and high-risk population.
Conclusions |
Hospitalized patients with cancer with rash and elevated IL-6 and TNF-α were nearly 6 times more likely to die over the course of follow-up. These biomarkers may serve as prognostic biomarkers and therapeutic targets for this high-risk population.
Le texte complet de cet article est disponible en PDF.Key words : biomarker, cytokine, drug-induced hypersensitivity syndrome, drug rash, drug reaction, drug reaction with eosinophilia and systemic symptoms, graft-versus-host disease, interleukin-6 (IL-6), mortality, severe cutaneous adverse reaction, survival, tumor necrosis factor alpha (TNF-α)
Abbreviations used : CI, CRS, GVHD, HR, IL, OS, SCAR, SJS, TEN, Th, TNF
Plan
| Funding sources: Dr Markova is supported by a Dermatology Foundation Career Development Award. This study was also funded in part by a grant from the National Cancer Institute/National Institutes of Health (P30-CA008748) made to the Memorial Sloan-Kettering Cancer Center. |
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| Disclosure: Dr Lacouture has served in consultant/speaking roles with Legacy Healthcare Services, ADC Therapeutics America Inc, Adgero Biopharmaceuticals, Amryt Pharmaceuticals, Apricity Health LLC, Azitra Inc, Celldex Therapeutics, Deciphera, Debiopharm, Galderma Research and Development, Johnson and Johnson, NCODA, Novocure Inc, Kyowa Kirin Inc, Lindi, Loxo, Merck Sharp and Dohme Corporation, Helsinn Healthcare SA, Janssen Research & Development LLC, Menlo Therapeutics, Novartis Pharmaceuticals Corporation, F. Hoffmann-La Roche AG, QED Therapeutics, AbbVie Inc, Boehringer Ingelheim Pharma Gmbh & Co KG, Allergan Inc, Amgen Inc, E.R. Squibb & Sons LLC, EMD Serono Inc, AstraZeneca Pharmaceuticals LP, Genentech Inc, Leo Pharma Inc, Seattle Genetics, Bayer, Manner SAS, Lutris, Pierre Fabre, Paxman Coolers, Adjucare, Dignitana, Biotechspert, Teva Mexico, Parexel, OnQuality Pharmaceuticals Ltd, Takeda Millennium, and Our Brain Bank; he also receives also receives research funding from Bristol-Myers Squibb, Lutris, Paxman, Novocure, US Biotest, and Veloce. Dr Markova has served on the advisory board of AstraZeneca and receives research funding from Incyte. Mr Stoll, Mr Vaidya, and Drs Mori and Dusza have no conflicts of interest to disclose. |
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| IRB approval status: Reviewed and approved by the IRB of Memorial Sloan Kettering Cancer Center. |
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| Reprints are not available from the authors. |
Vol 84 - N° 2
P. 273-282 - février 2021 Retour au numéro
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