Multilevel Chronic Stress and the Tumor Immune Environment: Is There a Connection?

By: Vanessa A. Carter, BS
Posted: Thursday, October 17, 2024

According to Alexandra R. Harris, PhD, MPH, MS, of the National Cancer Institute, Bethesda, Maryland, and colleagues, the biologic mechanisms behind the influence of chronic stress on tumor biology and the immune microenvironment of patients with breast cancer remain unknown. Through their study, which was presented during the 2024 American Association for Cancer Research (AACR) Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved (Abstract PR006) and published in Cancer Epidemiology, Biomarkers & Prevention, these investigators identified significant correlations between genetics and social disparities.

“Chronic stress, discrimination, inadequate social support, and neighborhood deprivation were associated with deleterious biological and immunological alterations to the local and systemic tumor immune environment in women with breast cancer, particularly for Black/African American women,” the study authors concluded.

From 2012 to 2023, this cross-sectional study collected 117 blood samples, 51 breast tumors, and 41 adjacent noncancerous tissues from women with breast cancer who were treated at the University of Maryland Medical Center. Participants filled out psychosocial and demographic questionnaires, and their associated biologic samples were analyzed for aberrations.

High tumor mutational burden was found to be associated with chronic stress alone (P = .059). Exposure to discrimination, chronic stress, and neighborhood deprivation appeared to correlate with systemic inflammation in the form of increased levels of TNFSF12A (P = .034) and serum interleukin-6 (IL-6; P = .014); aggressive tumor biology such as cellular stress, hypoxia, and proliferation; deleterious immune cell profiles, including tumor-associated M2 macrophages (P = .02); and antitumor immune response suppression. Of note, more favorable, immune-stimulatory changes such as increased serum IL-5 (P = .003) and activated natural killer cells in tumors of Black patients appeared to be a product of greater social support. Furthermore, race-stratified analyses identified a more pronounced negative biologic impact of these stressors among Black patients.

Disclosure: Disclosure information was not provided.

Cancer Epidemiology, Biomarkers & Prevention

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