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I read with great interest the Bun et al. study [1], in which investigated the association between cytokines and immune cells, such as myeloid-derived suppressor cells (MDSCs) and cytotoxic and regulatory T cells, to explore how these cytokines might affect the immune microenvironment in metastatic breast cancer (MBC) patients treated with eribulin. They concluded that baseline interleukin (IL)-6 is an important prognostic factor in patients with MBC treated with eribulin. Their results show that high IL-6 is associated with higher levels of MDSCs which suppress anti-tumor immunity, such as CD8+ cells. It appears that eribulin is not particularly effective in patients with high IL-6 due to a poor tumor immune microenvironment. IL-6 plays a major role in inflammatory processes. It modulates the transcription of several liver-specific genes during acute inflammatory states, particularly C-reactive protein (CRP). The prognostic impacts of preoperative CRP and interleukin (IL)-6 expression levels in patients with breast cancer remain controversial [2]. The authors did not measure serum CRP level. It would be expected to see a positive association between IL-6 and CRP levels. Moreover, CRP measurement is also more cost effective than IL-6 measurement in routine practice. This issue merits further investigation.
References
Bun A, Nagahashi M, Kuroiwa M, Komatsu M, Miyoshi Y (2023 Sep) Baseline interleukin-6 is a prognostic factor for patients with metastatic breast cancer treated with eribulin. Breast Cancer Res Treat 21. https://doi.org/10.1007/s10549-023-07086-9Epub ahead of print
Shimura T, Shibata M, Gonda K et al (2019) Prognostic impact of interleukin-6 and C-reactive protein on patients with breast cancer. Oncol Lett 17(6):5139–5146
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Altundag, K. Interleukin-6 and C-Reactive protein in metastatic breast cancer patients treated with eribulin. Breast Cancer Res Treat 203, 627 (2024). https://doi.org/10.1007/s10549-023-07156-y
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DOI: https://doi.org/10.1007/s10549-023-07156-y