Medical Oncology

, 33:54 | Cite as

Alterations in inflammatory biomarkers and energy intake in cancer cachexia: a prospective study in patients with inoperable pancreatic cancer

  • Asta ByeEmail author
  • Nima Wesseltoft-Rao
  • Per Ole Iversen
  • Grete Skjegstad
  • Kirsten B. Holven
  • Stine Ulven
  • Marianne J. Hjermstad
Original Paper


Chronic systemic inflammatory response is proposed as an underlying mechanism for development of cancer cachexia. We conducted a prospective study to examine changes in inflammatory biomarkers during the disease course and the relationship between inflammatory biomarkers and cachexia in patients with inoperable pancreatic cancer. Twenty patients, median (range) age 67.5 (35–79) years, 5 females, were followed for median 5.5 (1–12) months. Cachexia was diagnosed according to the 2011 consensus-based classification system (weight loss >5 % past six months, BMI < 20 kg/m2 and weight loss >2 %, or sarcopenia) and the modified Glasgow Prognostic score (mGPS) that combines CRP and albumin levels. Inflammatory biomarkers were measured by enzyme immunoassays. The patients had increased levels of most inflammatory biomarkers, albeit not all statistically significant, both at study entry and close to death, indicating ongoing inflammation. According to the consensus-based classification system, eleven (55 %) patients were classified as cachectic upon inclusion. They did not differ from non-cachectic patients with regard to inflammatory biomarkers or energy intake. According to the mGPS, seven (35 %) were defined as cachectic and had a higher IL-6 (p < 0.001) than the non-cachectic patients. They also had a slightly, but insignificantly longer survival than non-cachectic patients (p = 0.08). The mGPS should be considered as an additional framework for identification of cancer cachexia.


Advanced cancer Pancreatic cancer Cancer cachexia Inflammation Cytokines Adipokines 



The entire data collection was carried out at the Departments of Surgery, Oncology and Palliative Care at Oslo University Hospital. Appreciation is expressed to the staff of the study and to patients who participated.


This study was funded by Oslo and Akershus University College of Applied Sciences and Hole’s trust fund.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Asta Bye
    • 1
    • 2
    Email author
  • Nima Wesseltoft-Rao
    • 1
    • 3
  • Per Ole Iversen
    • 3
    • 4
  • Grete Skjegstad
    • 1
  • Kirsten B. Holven
    • 3
    • 5
  • Stine Ulven
    • 1
    • 3
  • Marianne J. Hjermstad
    • 2
    • 6
  1. 1.Department of Nursing and Health Promotion, Faculty of Health SciencesOslo and Akershus University College of Applied SciencesOsloNorway
  2. 2.Regional Centre for Excellence in Palliative Care, Department of OncologyOslo University HospitalOsloNorway
  3. 3.Department of Nutrition, Institute of Basic Medical SciencesUniversity of OsloOsloNorway
  4. 4.Department of HematologyOslo University HospitalOsloNorway
  5. 5.Norwegian National Advisory Unit on Familial Hypercholesterolemia, Department of Endocrinology, Morbid Obesity and Preventive MedicineOslo University HospitalOsloNorway
  6. 6.European Palliative Care Research Centre, Faculty of MedicineNorwegian University of Science and TechnologyTrondheimNorway

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