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Adjuvant Chemotherapy, Inflammatory Markers & Frailty in Older Adults

High levels of inflammatory markers such as interleukin-6 (IL-6) and C-reactive protein (CRP) may indicate an increased risk of functional decline and frailty in older women before they receive adjuvant chemotherapy for early breast cancer, researchers report. A prospective study of 295 robust women aged 65 years or older measured frailty status using a Deficit Accumulation Index (categorized as robust, prefrail, and frail) at before (T1) and after (T2) chemotherapy for stage I to III breast cancer. Based on a primary outcome of chemotherapy-induced decline in frailty status, the investigators found, “76 [women] (26%) experienced chemotherapy-induced decline in frailty status, among whom 66% had high IL-6, 63% had high CRP, and 46% had high IL-6 and CRP at T1. After adjusting for sociodemographic and clinical characteristics, women with high IL-6 and CRP had a > three-fold (odds ratio = 3.52; 95% CI, 1.55 to 8.01; P = .003) odds of chemotherapy-induced decline in frailty status compared with women with low IL-6 and CRP.”

“These studies may help individualize treatment decisions for older patients by identifying those who are at greater risk of functional decline with chemotherapy,” writes a Journal of Clinical Oncology editor in a relevance statement. “However, independent validation is critical before these results are incorporated into practice.”

Source: Journal of Clinical Oncology