Abstract
Gastrointestinal cancer (GI) is a major health problem. Patients with gastric, pancreatic, colorectal, bile duct and gall bladder cancer often have advanced disease at the time of diagnosis and are generally difficult to cure, resulting in a dismal prognosis for most patients. Inflammation plays an important role in the development and growth of cancer, which has led to a growing interest in the pro-inflammatory cytokine interleukin 6 (IL-6).The aim of the present review was to evaluate the clinical use of IL-6 as a biomarker or therapeutic target in patients with GI cancer. We did a systematic review of studies (1993–2018), to assess the clinical use of IL-6 as a diagnostic, prognostic or predictive tumor biomarker or as a potential therapeutic target.This review includes 48 studies and 5316 patients. Circulating IL-6 levels appear to be an independent prognostic biomarker in patients with GI cancer, with high IL-6 levels associated with short overall survival (OS). The results for colorectal cancer were too ambiguous to give conclusive results. IL-6 seemed to be a marker for some of the clinical characteristics of GI cancer, and may have a role in the diagnostic workup in general practice. No published studies have examined the use of IL-6 as a therapeutic target in pancreatic, gastric, bile duct or colorectal cancer.In conclusion, high circulating IL-6 was associated with short OS in most studies in GI cancer patients. Whether inhibition of IL-6 would decrease GI cancer symptoms and increase quality of life is unknown.
Highlights
Gastrointestinal (GI) cancer accounted for approximately 2.85 million new cases and 1.89 million deaths world-wide in 2012 [1]
We focus on gastric cancer, bile duct cancers, pancreatic cancer and colorectal cancer
This review aims to investigate whether circulating levels of interleukin 6 (IL-6) can be used as a diagnostic or prognostic biomarker in patients with Gastrointestinal cancer (GI) cancer and to assess its potential as a therapeutic target
Summary
Gastrointestinal (GI) cancer accounted for approximately 2.85 million new cases and 1.89 million deaths world-wide in 2012 [1]. We focus on gastric cancer, bile duct cancers, pancreatic cancer and colorectal cancer. These patients often present with locally advanced or metastatic disease at the time of diagnosis, and are not candidates for curative surgery [2,3,4,5,6,7]. In 2015, colorectal cancer was the second most common cancer in women, third in men, while it is the fourth leading cause of cancer deaths www.oncotarget.com in men and the third in women [3, 14, 15]. Gastric cancer is the fourth most common cancer and the third most common cause of cancer death [1, 15]. GI cancers are among the most common types of cancer, since colorectal and pancreatic cancer both were among the most common cancers in 2016 together with breast cancer, lung and bronchial cancer and prostate cancer [17]
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