More than 70% of head and neck cancer patients are affected by lymphedema and fibrosis.
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These common late effects of the disease and its treatment are invariably associated with a high symptom burden and decreased function and quality of life, yet there is still scant understanding of the biology of these phenomena.
In the current issue of
Lymphatic Research and Biology
, Ridner and colleagues have undertaken a novel approach to the lymphedema and fibrosis continuum in head and neck cancer, through prospective analysis of cytokine biomarkers associated with these phenomena. In their investigations, they explored the inter-relationships of specific interleukins, tumor growth factors, matrix metalloproteinases, C-reactive protein (CRP), interferon-gamma, and tumor necrosis factor α in this clinical setting. Eighty-three newly diagnosed patients were studied over a 72-month trajectory of treatment. Group-based trajectory modeling generated patient groups with similar longitudinal biomarker and lymphedema-fibrosis trajectories. The analysis disclosed a significant, statistically relevant association with lymphedema-fibrosis for the following pro-inflammatory cytokines: IL-6, IL-1β, TNF-α, TGF-β1, and MMP-9. Individual cytokines demonstrated distinct profiles of the relationship to temporal patterns and components of the lymphedema-fibrosis spectrum.
Biomarker analysis in lymphedema is still in its infancy,
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but this is a tool that is likely to explicate the biology of human lymphatic disease and to provide insights into risk stratification and, perhaps, therapeutics. Tissue responses to cancer interventions are complex; unraveling these complexities through molecular analysis is certain to be rewarded with expanding insights and interventions.
