Systematic review on associations of cancer-related fatigue with proinflammatory cytokines: IL-1alpha, IL-1beta, IL-6, TNF-alpha.
Hee-Ju Kim, Soyoun Park, Mi-Kyung Yuk et al.
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In 30 seconds
This systematic review examined associations between cancer-related fatigue and IL-1α, IL-1β, IL-6, and TNF-α in original studies of adults with cancer. It included 53 articles: 24 cross-sectional and 29 longitudinal studies. Cross-sectional findings were mixed, with most studies reporting no association for IL-6, TNF-α, or IL-1β. Longitudinal evidence more often linked higher IL-6 with greater fatigue: 67% of studies reported this association at least at one time point, particularly during or shortly after treatment. Treatment trajectory and other clinical factors may influence observed associations.
Key findings
- Among longitudinal studies, 67% reported an association between higher IL-6 and more severe fatigue at least at one time point, particularly during or shortly after treatment.
- Cross-sectional studies most often found no association: 63% for IL-6, 70% for TNF-α, and 71% for IL-1β.
- Most studies of TNF-α and the IL-1 family or their receptors reported no association with fatigue (70% for TNF and 69% for IL-1).
- Treatment, time since treatment, age, body-mass index, and depression were the most consistent modifying factors.
Why it matters
The review suggests that links between inflammatory markers and cancer-related fatigue may depend on when fatigue and cytokines are assessed, especially in relation to treatment. This helps frame fatigue as a potentially time-varying phenomenon and cautions against interpreting cytokine findings without considering clinical context and measurement methods.
What to keep in mind
The review reports mixed findings and methodological issues involving participant selection, measurements, and assay methods; the evidence includes heterogeneous cross-sectional and longitudinal studies.