The effect of recombinant GM-CSF on IL-6 and TNF-a levels in epithelial ovarian cancer patients who received paclitaxel and cisplatinum: preliminary results

Objective: We investigated the effects of GM-CSF factor on IL-6 and TNF-alpha levels prior to paclitaxel-cisplatinum combination chemotherapy for advanced epithelial ovarian cancer.

Materials and methods: Twenty-three consecutive patients with FIGO (International Federation of Gynecology and Obstetrics) Stage III-IV epithelial ovarian cancer were enrolled in the study. Following cytoreductive surgery patients received 175 mg/m2 paclitaxel and 75 mg/m2 cisplatinum on the same day. These 23 patients also received RhuGM-CSF five days before at a dose of 5 microg/kg/day by subcutaneous injection for three days. IL-6 and TNF-alpha levels were measured before and 24 hours later following the last dose of RhuGM-CSF.

Results: White blood cell counts on the 10th day of the cycle were lower than preGM-CSF white blood cell counts and the difference was statistically significant (p = 0.003). Platelet levels on the 10th day of the chemotherapy cycle were lower than pre GM-CSF levels, however were not statistically significant (p = 0.097). Post GM-CSF TNF-alpha and IL-6 levels were higher than pre GM-CSF levels. This difference was statistically significant for TNF-alpha (p = 0.002) however for IL-6 a statistically significant difference was not detected (p = 0.55). GM-CSF does not significantly effect IL-6 levels in contrast to TNF-alpha.

Conclusion: Clinical implications of increased levels of TNF-alpha are unclear and for a precise determination further studies are needed.

Recombinant GM-CSP; IL-6; TNF-a; Epithelial ovarian cancer

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