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

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.

Novel role of granulocyte-macrophage colony-stimulating factor: antitumor effects through inhibition of epithelial-to-mesenchymal transition in esophageal cancer

“…Recent studies have shown that GM-CSF has a much broader range of biological activities and exerts antitumor effects on cancer patients in an immune-dependent and -independent manner. A previous publication by our group showed that increased serum GM-CSF levels during radiotherapy were associated with better survival, which indicated the potential antitumor effects of GM-CSF, although the exact mechanism was unclear 22. Many other studies of pancreatic ductal adenocarcinoma have also provided supporting evidence for the antitumor effects of GM-CSF.…”

“…A previous publication by our group showed that increased serum GM-CSF levels during radiotherapy were associated with better survival, which indicated the potential antitumor effects of GM-CSF, although the exact mechanism was unclear. 22 Many other studies of pancreatic ductal adenocarcinoma have also provided supporting evidence for the antitumor effects of GM-CSF. Urdinguio et al 23 discovered that the 5-year survival rates were high in colon cancer patients overexpressing GM-CSF and their receptors.…”

Combination treatment with anti-HER2 therapeutic antibody RC48, PD-1 inhibitor, radiotherapy, and granulocyte macrophage-colony stimulating factor (GM-CSF) in patient with metastatic gastric cancer: a case report

“…A prospective clinical trial verifies that metastatic solid tumors treated with both radiotherapy and GM-CSF tend to experience tumor shrinkage ( 17 ). The increase in GM-CSF levels during radiotherapy correlates with longer PFS and OS in lung and esophageal cancer patients, indicating its potential as a prognostic biomarker ( 44 ). As distinct stages in triggering the immune response, radiotherapy, immunotherapy, and GM-CSF have the potential to enhance the efficacy against cancerous growths to different extents.…”