Resistance Training Does Not Protect Against Increases in Plasma Cytokine Levels Among Germ Cell Cancer Patients During and After Chemotherapy

Context: Testicular germ cell cancer (GCC) patients treated with cisplatin-etoposide-bleomycin chemotherapy (BEP) have excellent prognosis but have an increased risk of late-occurring morbidities, which may be associated with changes in the inflammatory profile. Objective: The objective of the study was to explore plasma cytokine concentrations in GCC patients randomized to resistance training or usual care during BEP, in comparison with healthy controls. Design/Setting: This was a randomized controlled trial in GCC patients enrolled from an oncology clinic, including a healthy reference group for comparison purposes. Outcome Measures: Plasma granulocyte macrophage colony-stimulating factor, interferon-gamma, IL-1 beta, IL-2, IL-6, IL-8, IL-10, IL-12, and TNF-alpha were measured in fasting blood samples from GCC patients randomized to resistance training (INT; n = 15) or usual care (CON; n = 15) and healthy age-matched controls (REF; n = 19). Clinical toxicity assessments and patient-reported end points were also recorded. Results: CON and INT were balanced at baseline. Compared with REF, CON had higher concentrations of IL-10, IL-6, and interferon-gamma, and INT had higher concentrations of IL-6, IL-8 and TNF-alpha (all P < .05). At the end of therapy, concentrations of IL-6, IL-8, and IL-10 increased in both GCC groups (all P < .01). Three months after therapy, all cytokine concentrations were comparable with the pretreatment levels in both GCC-groups but remained elevated compared with REF (P < .05). Changes in TNF-alpha correlated with pulmonary toxicity (P < .01). At the end of therapy, IL-6 concentrations correlated with quality of life (P < .05) and fatigue (P < .01). Conclusion: GCC patients treated with BEP display consistently elevated levels of systemic inflammatory markers compared with healthy controls. Resistance training during therapy has no impact on plasma cytokine concentrations.