This pilot study extends the specific aims of the previously funded R21 award through the use of Bio-Rad technology, which allows for multiple, simultaneous cytokine measures. In the R21, the cytokine analysis was limited by the blood required to do a single ELISA (approx 3 ccs) and the high cost of the individual cytokine assays. Using the Bio-Rad multiplex system, we will be able to assess the relationships among multiple cytokines, which will assist in the selection of cytokines as outcome measures for the forthcoming R01 grant application (June, 2006).

Due to the inconclusive results of previous studies and the heightened interest in better understanding and identifying the biological markers associated with fatigue and depressive symptoms, the specific aims of this study are to extend the R21 grant by

1. further describing the occurrence and severity of fatigue and depressive symptoms in women prior to their first chemotherapy treatment, and
2. exploring the relationship between each symptom (fatigue and depressive symptoms) and theoretically related proinflammatory and angiogenic cytokines as well as cytokine profiles using recent innovations in measurement systems.

Serum for this study will be accessed from the samples previously obtained and cryopreserved for the larger study, 7 R21 CA106149-02, Cranial Stimulation for Chemo Symptoms in Breast Cancer (Lyon, Debra E., PI). We will use the sera collected prior to the first chemotherapy because of the potential confounding effects of chemotherapy on cytokine expression.