Elevated serum granulocyte-macrophage colony-stimulating factor levels during radiotherapy predict favorable outcomes in lung and esophageal cancer.

Guodong Deng,Hui Luo,Jiandong Zhang,Zhen Liu,Yajuan Lv,Fengjun Liu,Qiqi Liu,Pingping Hu,Xinshuang Yu,Jingxin Zhang,Deguo Xu,Jian Xie,Ning Liang,Lili Qiao

doi:10.18632/oncotarget.13202

Abstract

The combination of exogenous granulocyte-macrophage colony-stimulating factor (GM-CSF) with radiotherapy (RT) has been demonstrated to strengthen the antitumor immune response. We hypothesized that the variation of GM-CSF during RT was correlated with cancer prognosis. We measured serum levels of GM-CSF and interferon-γ (IFN-γ) before and during RT in 126 unresectable lung and esophageal cancer patients and performed survival analyses. Upregulated GM-CSF levels during RT correlated with longer overall survival (OS) and progression-free survival (PFS). On the other hand, no difference in OS or PFS was seen at different IFN-γ levels. However, the “integrated factor”, computed as the combination of high pre-RT IFN-γ levels and upregulated GM-CSF, correlated with prolonged OS and PFS. Multivariate analyses revealed that GM-CSF levels and the integrated factor were both stronger independent prognostic factors than disease stage. These data demonstrate that GM-CSF levels during RT can be used as a prognostic biomarker for lung and esophageal cancer.

Highlights

Lung cancer (LC) and esophageal cancer (EC) are both the most frequently diagnosed cancers and the leading causes of cancer death worldwide [1]
As a basic cytokine stimulating the immune system, granulocyte-macrophage colony-stimulating factor (GM-CSF) plays its therapeutic role against cancer by potentiating the antitumor effects of other molecules or treatments, such as RT [5, 18]
In the current study we demonstrated that upregulated serum GM-CSF during RT is a positive prognostic factor for LC and EC patients

Summary

Introduction

Lung cancer (LC) and esophageal cancer (EC) are both the most frequently diagnosed cancers and the leading causes of cancer death worldwide [1]. In spite of recent progress in diagnosis and treatment, recurrence and mortality rates remain high for LC and EC [2, 3]. Such poor prognosis might be at least partially attributable to the lack of effective prognostic factors to inform on optimal therapeutic choices. Granulocyte macrophage colony-stimulating factor (GM-CSF) is a glycoprotein mainly secreted by immune cells, fibroblasts, endothelial cells and some tumor cells [4]. It is a common growth factor for blood cells, used in myelosuppression resulting from chemoradiotherapy. Both experimental and clinical applications of GM-CSF or GMCSF-encoded tumor vaccine as cancer therapies showed promising results [8,9,10,11]

Methods

Results

Conclusion