Pretreatment TNF Level May Be Associated With Memory Impairment in Women With Newly Diagnosed Breast Cancer


Key Points

  • Higher pretreatment levels of tumor necrosis factor were associated with poorer memory function in patients with breast cancer prior to treatment.
  • Comorbidity accounted for variance in processing speed and executive function in patients with breast cancer.

In a study reported in the Journal of the National Cancer Institute, Patel et al found that inflammatory cytokine levels were associated with poorer memory function in women with newly diagnosed breast cancer, with higher pretreatment levels of soluble tumor necrosis factor (TNF) receptor type 2 (sTNF-RII) being a significant predictor of impairment.

Study Details

A total of 174 postmenopausal women with newly diagnosed disease who had not yet undergone treatment and age-matched controls without cancer underwent comprehensive assessment of cognitive function, mood, and fatigue and measurement of levels of circulating interleukin-6 (IL-6), interleukin-1 receptor antagonist (IL-1ra), and sTNF-RII.

Associations With Poorer Function

Memory performance was significantly poorer in patients vs controls (P = .02). Among the cytokines, only the IL-1ra level was significantly higher in patients vs controls (P = .007).

In analysis controlling for  age, education, race, mood, fatigue, body mass index, and comorbidity, cytokines independently accounted for 6% of the total variance in memory performance (P = .01) in patients with cancer but not controls; in post hoc analysis, sTNF-RII was the only cytokine independently predictive of memory function, with higher levels being associated with poorer function (P = .01). In exploratory analyses, comorbidity accounted for variance in processing speed (P = .03) and executive functioning (P = .03) in patients with cancer.

The investigators concluded: “An association of TNF with memory, previously reported in patients after exposure to chemotherapy, was found prior to initiation of any treatment, including surgery. This association requires further investigation as sTNF-RII was not higher in cancer patients relative to control participants.”

Sunita K. Patel, PhD, of City of Hope Medical Center, is the corresponding author of the Journal of the National Cancer Institute article.

The study was funded by grants from the National Cancer Institute and the University of California, Los Angeles (UCLA) and by the UCLA Cousins Center for Psychoneuroimmunology.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.