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Symptom clusters of pain, depressed mood, and fatigue in lung cancer: assessing the role of cytokine genes

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Abstract

Purpose

Symptom clusters, the multiple, co-occurring symptoms experienced by cancer patients, are debilitating and affects quality of life. We assessed if a panel of immune-response genes may underlie the co-occurrence of severe pain, depressed mood, and fatigue and help identify patients with severe versus non-severe symptom clusters.

Methods

Symptoms were assessed at presentation, prior to cancer treatment in 599 newly diagnosed lung cancer patients. We applied cluster analyses to determine the patients with severe versus non-severe symptom clusters of pain, depressed mood, and fatigue.

Results

Two homogenous clusters were identified. One hundred sixteen patients (19 %) comprised the severe symptom cluster, reporting high intensity of pain, depressed mood, and fatigue and 183 (30 %) patients reported low intensity of these symptoms. Using Bayesian model averaging methodology, we found that of the 55 single nucleotide polymorphisms assessed, an additive effect of mutant alleles in endothelial nitric oxide synthase (-1474 T/A) (posterior probability of inclusion (PPI) = 0.78, odds ratio (OR) = 0.54, 95 % credible interval (CI) = (0.31, 0.93)); IL1B T-31C (PPI = 0.72, OR = 0.55, 95 % CI = (0.31, 0.97)); TNFR2 Met196Arg (PPI = 0.70, OR = 1.85, 95 % CI = (1.03, 3.36)); PTGS2 exon 10+837T > C (PPI = 0.69, OR = 0.54, 95 % CI = (0.28, 0.99)); and IL10RB Lys47Glu (PPI = 0.68; OR = 1.74; 95 % CI = (1.04, 2.92)) were predictive for symptom clusters.

Conclusions

Genetic polymorphisms may facilitate identification of high-risk patients and development of individualized symptom therapies.

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Acknowledgments

CA109043, CA128069, CA127219, CA123109, and DE022891 from the National Institutes of Health and is supported in part by the NIH/NCI through MD Anderson’s Cancer Center Support grant CA016672.

Conflict of interest

All authors have no potential conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Unit 1468, 1155 Pressler Street, Houston, TX, 77030-4009, USA

    Cielito C. Reyes-Gibby

  2. University of Texas Health Science Center at Houston School of Public Health, Houston, USA

    Michael D. Swartz & Xiaoying Yu

  3. Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Unit 1340, 1155 Pressler Street, Houston, TX, 77030-4009, USA

    Xifeng Wu

  4. Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Unit 1414,1155 Pressler Street, Houston, TX, 77030-4009, USA

    Sriram Yennurajalingam

  5. Department of Symptoms Research, The University of Texas MD Anderson Cancer Center, Unit 1450, 1155 Pressler Street, Houston, TX, 77030-4009, USA

    Karen O. Anderson

  6. The Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, USA

    Margaret R. Spitz

  7. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Unit 1411, 1400 Pressler Street, Houston, TX, 77030-4009, USA

    Sanjay Shete

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  1. Cielito C. Reyes-Gibby
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Correspondence to Cielito C. Reyes-Gibby.

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Reyes-Gibby, C.C., Swartz, M.D., Yu, X. et al. Symptom clusters of pain, depressed mood, and fatigue in lung cancer: assessing the role of cytokine genes. Support Care Cancer 21, 3117–3125 (2013). https://doi.org/10.1007/s00520-013-1885-5

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  • DOI: https://doi.org/10.1007/s00520-013-1885-5

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