Inflammatory Signatures Associated with Obesity in Patients with Stage II Breast Cancer Receiving Doxorubicin- Cyclophosphamide Therapy

Mohanad  Luay Jawhar; Mahmood Abed Hamzah; Baraa  Ahmed Saeed; Noor Yahya Muneer; Anwer Jaber Faisal

doi:10.31557/APJCB.2026.11.4.989

Authors

Mohanad Luay Jawhar Ibn Sina University of Medical and Pharmaceutical Sciences, Baghdad, Iraq.
Mahmood Abed Hamzah Ministry of Education, Al- Karkh3, Baghdad, Iraq.
Baraa Ahmed Saeed Ibn Sina University of Medical and Pharmaceutical Sciences, Baghdad, Iraq.
Noor Yahya Muneer Ibn Sina University of Medical and Pharmaceutical Sciences, Baghdad, Iraq
Anwer Jaber Faisal 3Iraqi Center for Cancer and Medical Genetic Research, Mustansiriyah University, Baghdad, Iraq.

DOI:

https://doi.org/10.31557/APJCB.2026.11.4.989

Keywords:

Breast cancer, Obesity, Chemotherapy, Inflammatory biomarkers, Leptin

Abstract

Background: Obesity is being considered as a biological factor in altering the progression of breast cancer, as well as potentially influencing the response to treatment. It is marked by persistent low-level systemic inflammation mediated by adipose tissue-derived adipokines and cytokines, which can affect the tumor microenvironment and tumor response to chemotherapy. The objective of the study was to investigate the correlation between body mass index (BMI) and obesity-related inflammatory biomarkers in stage II breast cancer patients on the doxorubicin-cyclophosphamide chemotherapy.

Materials and Methods: An analytical study was conducted on 120 Iraqi women having stage II breast cancer that was confirmed by histology. Every patient was given doxorubicin and cyclophosphamide depending on the body surface area (BSA) and evaluated in the third round of chemotherapy. BMI was used in stratifying the patients on the basis of normal weight, overweight, and obese conditions (40 per group). Leptin, interleukin-1β (IL-1β), high-sensitivity C-reactive protein (hs-CRP), monocyte chemoattractant protein-1 (MCP-1), and cancer antigen 15-3 (CA15-3) serum concentrations were determined by means of standardized ELISA kits. The BioTek ELx800tm microplate reader was used to read absorbance.

Results: Leptin, IL-1β, hs-CRP, and MCP-1 were much higher in overweight and obese patients than in normal-weight patients, which showed that systemic inflammation is progressive in obesity. The serum level of CA15-3 was materially greater in the overweight and obese breast cancer patients than in the normal-weight patients, and also, there was no significant difference between the overweight and obese groups.

Conclusion: The adipokine-rich and inflammatory profile of doxorubicin-cyclophosphamide chemotherapy in obese women with stage II breast cancer is linked to obesity. The results point to the possibility of obesity-related inflammation in the formation of the biological context of chemotherapy and justify the use of inflammatory profiling in individual breast cancer management.