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Serum IL6 as a Prognostic Biomarker and IL6R as a Therapeutic Target in Biliary Tract Cancers

Biliary tract cancer (BTC) is a heterogeneous group of rare gastrointestinal malignancies with dismal prognosis often associated with inflammation. We assessed the prognostic value of IL6 and YKL-40 compared with CA19-9 before and during palliative chemotherapy. We also investigated in mice whether...

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Published in:Clinical cancer research 2020-11, Vol.26 (21), p.5655-5667
Main Authors: Høgdall, Dan, O'Rourke, Colm J, Dehlendorff, Christian, Larsen, Ole F, Jensen, Lars H, Johansen, Astrid Z, Dang, Hien, Factor, Valentina M, Grunnet, Mie, Mau-Sørensen, Morten, Oliveira, Douglas V N P, Linnemann, Dorte, Boisen, Mogens K, Wang, Xin W, Johansen, Julia S, Andersen, Jesper B
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cited_by cdi_FETCH-LOGICAL-c411t-7b4bbee7756696a72c3b4813864053be9092925b9d68fbcd307594af6f5d2a0f3
cites cdi_FETCH-LOGICAL-c411t-7b4bbee7756696a72c3b4813864053be9092925b9d68fbcd307594af6f5d2a0f3
container_end_page 5667
container_issue 21
container_start_page 5655
container_title Clinical cancer research
container_volume 26
creator Høgdall, Dan
O'Rourke, Colm J
Dehlendorff, Christian
Larsen, Ole F
Jensen, Lars H
Johansen, Astrid Z
Dang, Hien
Factor, Valentina M
Grunnet, Mie
Mau-Sørensen, Morten
Oliveira, Douglas V N P
Linnemann, Dorte
Boisen, Mogens K
Wang, Xin W
Johansen, Julia S
Andersen, Jesper B
description Biliary tract cancer (BTC) is a heterogeneous group of rare gastrointestinal malignancies with dismal prognosis often associated with inflammation. We assessed the prognostic value of IL6 and YKL-40 compared with CA19-9 before and during palliative chemotherapy. We also investigated in mice whether IL6R inhibition in combination with gemcitabine could prolong chemosensitivity. A total of 452 Danish participants with advanced (locally advanced and metastatic) BTC were included from six clinical trials (February 2004 to March 2017). Serum CA19-9, IL6, and YKL-40 were measured before and during palliative treatment. Associations between candidate biomarkers and progression-free survival (PFS) and overall survival (OS) were analyzed by univariate and multivariate Cox regression. Effects of inhibiting IL6R and YKL-40 were assessed , and of IL6R inhibition . High pretreatment levels of CA19-9, IL6, and YKL-40, and increasing levels during treatment, were associated with short PFS and OS in patients with advanced BTC. IL6 provided independent prognostic information, independent of tumor location and in patients with normal serum CA19-9. ROC analyses showed that IL6 and YKL-40 were predictive of very short OS (OS < 6 months), whereas CA19-9 was best to predict OS > 1.5 years. Treatment with anti-IL6R and gemcitabine significantly diminished tumor growth when compared with gemcitabine monotherapy in an transplant model of BTC. Serum IL6 and YKL-40 are potential new prognostic biomarkers in BTC. IL6 provides independent prognostic information and may be superior to CA19-9 in certain contexts. Moreover, anti-IL6R should be considered as a new treatment option to sustain gemcitabine response in patients with BTC.
doi_str_mv 10.1158/1078-0432.CCR-19-2700
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We assessed the prognostic value of IL6 and YKL-40 compared with CA19-9 before and during palliative chemotherapy. We also investigated in mice whether IL6R inhibition in combination with gemcitabine could prolong chemosensitivity. A total of 452 Danish participants with advanced (locally advanced and metastatic) BTC were included from six clinical trials (February 2004 to March 2017). Serum CA19-9, IL6, and YKL-40 were measured before and during palliative treatment. Associations between candidate biomarkers and progression-free survival (PFS) and overall survival (OS) were analyzed by univariate and multivariate Cox regression. Effects of inhibiting IL6R and YKL-40 were assessed , and of IL6R inhibition . High pretreatment levels of CA19-9, IL6, and YKL-40, and increasing levels during treatment, were associated with short PFS and OS in patients with advanced BTC. IL6 provided independent prognostic information, independent of tumor location and in patients with normal serum CA19-9. ROC analyses showed that IL6 and YKL-40 were predictive of very short OS (OS &lt; 6 months), whereas CA19-9 was best to predict OS &gt; 1.5 years. Treatment with anti-IL6R and gemcitabine significantly diminished tumor growth when compared with gemcitabine monotherapy in an transplant model of BTC. Serum IL6 and YKL-40 are potential new prognostic biomarkers in BTC. IL6 provides independent prognostic information and may be superior to CA19-9 in certain contexts. 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Johansen and J.B. Andersen contributed equally to this article.</notes><notes>D. Høgdall: Conceptualization, resources, data curation, formal analysis, supervision, funding acquisition, validation, investigation, visualization, methodology, writing-original draft, project administration, writing-review and editing. C.J. O’Rourke: Conceptualization, resources, data curation, formal analysis, supervision, validation, visualization, methodology, writing-original draft, writing-review and editing. C. Dehlendorff: Data curation, formal analysis, validation, methodology, writing-original draft, writing-review and editing. O.F. Larsen: Conceptualization, data curation, supervision, project administration, writing-review and editing. L.H. Jensen: Resources, data curation, writing-review and editing. A.Z. Johansen: Resources, data curation, formal analysis, writing-original draft, writing-review and editing. H. Dang: Conceptualization, resources, data curation, formal analysis, supervision, project administration, writing-review and editing. V.M. Factor: Data curation, supervision, methodology, project administration, writing-review and editing. M. Grunnet: Resources, data curation, writing-review and editing. M. Mau-Sørensen: Resources, data curation, writing-review and editing. D.V.N.P Oliveira: Resources, writing-review and editing. D. Linnemann: Resources, data curation, formal analysis, supervision, methodology, writing-review and editing. M.K. Boisen: Conceptualization, data curation, supervision, validation, methodology, writing-review and editing. X.W. Wang: Resources, data curation, supervision, methodology, writing-review and editing. J.S. Johansen: Conceptualization, resources, data curation, formal analysis, supervision, funding acquisition, validation, investigation, visualization, methodology, project administration, writing-review and editing. J.B. Andersen: Conceptualization, resources, data curation, formal analysis, supervision, funding acquisition, validation, methodology, project administration, writing-review and editing.</notes><abstract>Biliary tract cancer (BTC) is a heterogeneous group of rare gastrointestinal malignancies with dismal prognosis often associated with inflammation. We assessed the prognostic value of IL6 and YKL-40 compared with CA19-9 before and during palliative chemotherapy. We also investigated in mice whether IL6R inhibition in combination with gemcitabine could prolong chemosensitivity. A total of 452 Danish participants with advanced (locally advanced and metastatic) BTC were included from six clinical trials (February 2004 to March 2017). Serum CA19-9, IL6, and YKL-40 were measured before and during palliative treatment. Associations between candidate biomarkers and progression-free survival (PFS) and overall survival (OS) were analyzed by univariate and multivariate Cox regression. Effects of inhibiting IL6R and YKL-40 were assessed , and of IL6R inhibition . High pretreatment levels of CA19-9, IL6, and YKL-40, and increasing levels during treatment, were associated with short PFS and OS in patients with advanced BTC. IL6 provided independent prognostic information, independent of tumor location and in patients with normal serum CA19-9. ROC analyses showed that IL6 and YKL-40 were predictive of very short OS (OS &lt; 6 months), whereas CA19-9 was best to predict OS &gt; 1.5 years. Treatment with anti-IL6R and gemcitabine significantly diminished tumor growth when compared with gemcitabine monotherapy in an transplant model of BTC. Serum IL6 and YKL-40 are potential new prognostic biomarkers in BTC. IL6 provides independent prognostic information and may be superior to CA19-9 in certain contexts. Moreover, anti-IL6R should be considered as a new treatment option to sustain gemcitabine response in patients with BTC.</abstract><cop>United States</cop><pmid>32933994</pmid><doi>10.1158/1078-0432.CCR-19-2700</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record>
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ispartof Clinical cancer research, 2020-11, Vol.26 (21), p.5655-5667
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source Freely Accessible Science Journals
subjects Adult
Aged
Aged, 80 and over
Animals
Antigens, Tumor-Associated, Carbohydrate - blood
Antigens, Tumor-Associated, Carbohydrate - genetics
Antineoplastic Combined Chemotherapy Protocols - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Biliary Tract Neoplasms - blood
Biliary Tract Neoplasms - drug therapy
Biliary Tract Neoplasms - genetics
Biliary Tract Neoplasms - pathology
Biomarkers, Tumor - blood
Cell Proliferation - drug effects
Chitinase-3-Like Protein 1 - blood
Chitinase-3-Like Protein 1 - genetics
Deoxycytidine - administration & dosage
Deoxycytidine - adverse effects
Deoxycytidine - analogs & derivatives
Disease-Free Survival
Female
Humans
Interleukin-6 - blood
Interleukin-6 - genetics
Male
Mice
Middle Aged
Palliative Care
Prognosis
Progression-Free Survival
Receptors, Interleukin-6 - antagonists & inhibitors
Receptors, Interleukin-6 - blood
Receptors, Interleukin-6 - genetics
title Serum IL6 as a Prognostic Biomarker and IL6R as a Therapeutic Target in Biliary Tract Cancers
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