1673P - Trajectories of immune-related serum proteins and quality of life in patients with pancreatic and other periampullary cancer: The champ study

Background

There is still a profound lack of efficient therapeutic strategies against pancreatic or other periampullary adenocarcinoma. Surgery is seldom possible, leaving palliative chemotherapy the only option for most patients. Chemotherapy treatment is however often accompanied by serious side-effects, and the identification of biomarkers for early prediction of disease and treatment-associated symptoms could help alleviate patient suffering. This study investigated the dynamic interrelationship between immune-related serum proteins, routine biomarkers and health-related quality of life (HRQoL) factors during chemotherapy treatment of patients enrolled in the prospective, observational study Chemotherapy, Host response And Molecular dynamics in Periampullary cancer (CHAMP).

Methods

Proximity extension assay was applied to analyse 92 immune-associated proteins in longitudinal serum samples from 75 patients, 18 being treated with adjuvant and 57 with palliative intent. HRQoL data were available from all patients at baseline (BL), from 41 patients at three months, and from 23 patients at six months.

Results

Levels of 8 proteins; CCL23, CD4, CD28, DCN, Gal-1, GZMB, GZMH and MMP7 were strongly correlated (Spearman´s Rho ≤-0.6 or ≥0.6) with various symptoms (insomnia, dyspnea, cognitive and emotional functioning) during treatment. Associations between routine laboratory parameters albumin, CA19-9, CEA and CRP and HRQoL were overall weaker. None of the investigated proteins were associated with pain.

Conclusions

This is, to our knowledge, the first study exploring associations between serum biomarkers and HRQoL in patients with pancreatic or other periampullary cancer, and some findings merit further validation. The proteoglycan decorin (DCN) is of particular interest as it has been linked to conditions such as Alzheimer’s disease and schizophrenia. Chemotherapy is known to cause persistent cognitive dysfunction with effects on memory and executive function, referred to as “chemo brain”. It would therefore be of great value to identify biomarkers for early detection and management of this debilitating condition.

Clinical trial identification

NCT03724994.

Editorial acknowledgement

Legal entity responsible for the study

Region Skåne.

Funding

This work is supported by peer reviewed grants from the Swedish Research Council (grant number 2015-03598 and 2018-02441), the Swedish Cancer Society (grant number CAN 2018/418 and 21 1596 Pj), the SjöbergFoundation, the Lennart GlansFoundation, BioCARE, the Mrs Berta KampradFoundation, the Ingrid and Sverker PerssonFoundation, the Faculty of Medicine, Lund University, Governmental Funding of Clinical Research (ALF), and Skåne University Hospital Donations and Funds.

Disclosure

All authors have declared no conflicts of interest.