CC-chemokine ligand 5 (CCL5) was measured in plasma of 238 patients with breast cancer and in serum of 149 of these patients. Mean circulating CCL5 levels tended to be higher in patients with lymph-node-positive breast cancer, larger tumour sizes, the presence of lymphovascular invasion, and multifocal tumours. Additionally, circulating CCL5 levels were higher in the order of stages III, II, and I. The addition of circulating CCL5 concentration to known clinicopathological predictors for lymph node involvement did not allow more precise prediction of the lymph node status. These results suggest that CCL5 is a biomarker for tumour load rather than for lymph node involvement. As such, it might be helpful to identify patients with escape from immunosurveillance who will benefit from therapies to restore immune function. 1. Introduction CC-chemokine ligand 5 (CCL5), previously called RANTES (Regulated on Activation, Normal T cell Expressed and Secreted), belongs to the family of the CC chemokines. The major role of chemokines is to act as chemoattractants to guide the migration of cells. Some chemokines control cells of the immune system during processes of immune surveillance. Others are inflammatory and mainly attract leukocytes to sites of inflammation and/or infection. Their release is stimulated by pro-inflammatory cytokines. Thus, chemokines coordinate intricate leukocyte trafficking patterns that regulate immune responses against cancer. These are multistep processes that involve localization of immune effectors to appropriate sites, antigen presentation, and optimal triggering of specific T cells. It is increasingly clear that cancer-mediated modulation of the host immune response contributes to tumour progression and correlates with patient outcome [1]. Indeed, tumours can evade immunosurveillance through altering the properties and functions of host stromal and/or immune cells. They polarize the tumour microenvironment towards chronic inflammatory states, leading to impaired tumor cell killing and to tumour escape. The exact functions of CCL5 in tumour biology are still unclear. On the one hand, CCL5 is important to trigger and amplify the anti-tumour host response. Besides its role as a potent chemoattractant, CCL5 plays an important role in T-cell responses. Therefore, production of CCL5 is important for inducing proper immune responses against tumours [2]. On the other hand, it has been reported that CCL5 is associated with cancer progression and metastasis because it promotes tumour cell survival, proliferation, and invasion [3]. CCL5 can be
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