Clinical implications of insulin-like growth factor I (IGF-I) and II (IGF-II) in stage IIIB cervical cancer.

Abstract

e15505 Background: The IGF (Insulin like Growth Factor) family has been implicated in the pathogenesis of cervical cancer. We aim to correlate pre and post treatment levels of IGF-I and IGF-II in stage IIIB cervical cancer and identify if serum IGF-I and IGF-II can be used as a marker to predict response to chemo-radiotherapy. Methods: We recruited 80 previously untreated patients of histopathologically proven squamous cell carcinoma of stage IIIB cancer of uterine cervix from January 2011 to May 2011. The age of patients ranged from 30 to 65 years and were of ECOG performance status of less than or equal to 2. Along with the routine investigations the pretreatment serum levels of IGF-I and IGF-II were done by ELISA kits in all the patients. The serum level of IGF-I was 246.3 ± 72.5 ng/ml and IGF-II was 1585 ± 352 ng/ml. All patients were given concurrent cisplatin (30 mg/m2) weekly along with radiation (50Gy/25#) with conventional portals followed by two sittings of intracavitory radiotherapy (7.5 Gy each) on mHDR. Blood samples for IGF-I and IGF-II levels were collected before the start of the therapy, 1 month after the completion of treatment and 6 months after the completion of the treatment. Results: The trend seen was that mean IGF-I levels were always in the lower range as compared to IGF-II levels in all individuals. The mean serum levels of IGF-I and IGF-II in patients who achieve complete response (45%) returned to normal whereas the mean serum levels of IGF-I and IGF-II in patients who achieved partial response (43%) was 149 ng/ml and 838 ng/ml respectively. The mean serum levels of IGF-I and IGF-II in patients who achieved no response (12%) was 331 ng/ml and 1840 ng/ml respectively. Conclusions: The serum levels of IGF-I and IGF-II may be a reliable prognostic and predictive marker in cervical cancer however further large randomized studies are required to validate the results. IGF-I and IGF-II can serve as potential markers in cervical cancer to risk stratify patients, assess treatment response and possibly act as therapeutic targets in the future.