Inflammation potentially involved in survival in gallbladder cancer patients
In patients with gallbladder cancer (GBC), reducing and controlling inflammation, as well as targeting relevant pathways, may improve patient outcomes and survival, according to a recent study.
In a Shanghai cohort consisting of 134 GBC patients, researchers identified eight inflammatory proteins significantly associated with survival. Elevated levels of seven of the proteins were correlated with poor overall survival, with hazard ratios (HR) ranging from 2.49 (95 percent CI, 1.41–4.41) for chemokine (C-C motif) ligand 20 (CCL20) to 3.77 (1.98–7.19) for soluble tumour necrosis factor-alpha receptor II (sTNFRII).
One inflammatory protein, tumour necrosis factor-related apoptosis-inducing ligand (TRAIL), showed a positive and significant correlation with better survival (HR for fourth vs first quartile, 0.26; 0.14–0.47; p=8.3x10-5 for trend). The survival benefit associated with TRAIL was significant only in GBC patients with late-stage disease (HR, 0.63; 0.51–0.77) but not in those with early-stage disease (HR, 1.05; 0.65–1.71).
Researchers validated the findings in a 35-patient Chile cohort, in which data were present for only seven of the original eight proteins. They found that four inflammatory proteins remained associated with poorer survival, while an elevated TRAIL concentration was still correlated with better survival.
According to researchers, proinflammatory cytokines, growth factors, cytokines, chemokines and acute-phase proteins may have a potential role in the severity and progression of GBC and warrant further research.
“[F]urther studies among patients with GBC are required, including placebo-controlled trials of TRAIL-related anticancer drug or anti-inflammatory agents as adjuncts to other routine therapies,” they said.