Prognostic implication of inflammation-based scores in patients with metastatic pancreatic cancer (mPC) treated with first-line nab-paclitaxel plus...

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Pancreatic Cancer
Presenter Hei Nga Natalie Ip
Citation Annals of Oncology (2018) 29 (suppl_9): ix46-ix66. 10.1093/annonc/mdy432
Authors H.N.N. Ip1, I. Hwang2, J. Kang2, K. Kim2, J.H. Jeong2, H. Chang2, B. Ryoo2, C. Yoo2
  • 1Medicine, The Chinese University of Hong Kong, N/A - Shatin/HK
  • 2Oncology, Asan Medical Center, NA - Seoul/KR

Abstract

Background

AG is standard first-line Chemotherapy for patients with mPC. However, prognostic factors for patients with mPC treated with AG are largely unknown. This retrospective analysis was performed to identify the prognostic factors including inflammation-based prognostic scores in mPC patients treated with AG as first-line treatment.

Methods

A total of 203 patients with histologically confirmed recurrent (n = 55) or metastatic (n = 148) pancreatic cancer who were treated with first-line AG in Asan Medical Center, Seoul, Korea, between January 2013 and January 2018, were included in this analysis. As inflammation-based scores, baseline Neutrophil-lymphocyte ratio (NLR), Platelet-lymphocyte ratio (PLR) and modified Glasgow prognostic score (mGPS) were tested. Cox-proportional hazards model were used to identify prognostic factors in univariate and multivariate analyses.

Results

Median age was 62 years (range, 32-82) and 116 patients (57%) were male. With median follow-up duration of 21.5 months (range, 0.5-34.3), median overall survival (OS) and progression-free survival (PFS) in overall patients were 7.1 (95% CI, 6.2-8.0) and 15.1 (95% CI 12.6-17.6) months, respectively. In multivariate analysis, elevated CA19-9 level (HR 1.75, p = 0.008), liver metastasis (HR 1.8, p = 0.001), distant lymph node metastasis (HR 1.4, p = 0.04), high mGPS (≥1 vs.0: HR 1.6, p = 0.005) were significantly associated with poorer OS. For PFS, poor performance status (PS) (ECOG PS ≥ 2 vs 1: HR 2.1, p = 0.048), liver metastasis (HR 1.4, p = 0.03), distant lymph node metastasis (HR 1.5, p = 0.02), and elevated CA 19-9 level (HR 1.1, p = 0.02) were significantly related with poorer outcomes. Neither NLR nor PLR was significantly associated with PFS or OS.

Conclusions

CA19-9 level, liver and distant lymph node metastasis were independent prognostic factors in mPC patients treated with first-line AG. Among the inflammation based prognostic scores, mGPS may be the reliable indicator for the prediction of OS.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.