Abstract 189P
Background
Inflammation-based score such as Glasgow prognostic score (GPS) or Neutrophil -Lymphocyte ratio (NLR) is associated with clinical outcome of cancer patients. However, the prognostic value of GPS and NLR for patients with advanced pancreatic cancer who received systemic chemotherapy remains unclear.
Methods
We conducted single center retrospective study. Inclusion criteria was defined as patients with metastatic or recurrent pancreatic cancer treated with FFX or GnP as first line treatment at Hokkaido university hospital between January 2014 and December 2018. Baseline GPS was identified that GPS 0 was CRP ≤1.0 mg/dL and Alb ≥3.5 g/dL, GPS 1 was CRP >1.0 mg/dL or Alb <3.5 g/dL, and GPS 2 was CRP >1.0 mg/dL and Alb <3.5 g/dL. NLR was defined as the ratio of absolute neutrophil count and absolute lymphocyte count. As no clear NLR cutoff level has been established in this setting, we used the cutoff ≧3. Cox-proportional hazards model were used to identify prognostic factors in univariate and multivariate analyses.
Results
A total of 101 patients were eligible. Median age of patients was 67, male/female was 63/38, ECOG PS 0/1/2 was 36/62/3, FFX/GnP was 19/82, GPS 0/1/2/unknown was 52/21/23/5, NLR ≧3/<3/unknown was 51/44/6, respectively. In GPS 0/1-2 patients, median PFS were 5.2/2.3months (HR 1.772, 95%CI 1.165-2.693, p=0.007), median OS were 12.4/5.7 months (HR 2.384, 95%CI 1.534-3.706, p<0.001), respectively. In NLR 3≧3 patients, median PFS were 6.4/2.6 months (HR 2.436, 95%C.I. 1.568-3.784, p<0.001), median OS were 14.6/6.0 months (HR 2.496, 95% C.I. 1.616-3.856, p<0.001), respectively. In multivariate analysis, High NLR (NLR ≧3 vs <3 : HR 2.067, 95%C.I. 1.278-3.343, p=0.003) was significantly associated with poor PFS. For OS, female (HR 2.006, 95%C.I. 1.206-3.34, p=0.007), liver metastasis (HR 2.137, 95%C.I. 1.281-3.565, p=0.004), high NLR (NLR ≧3 vs <3: HR 2.745, 95%C.I. 1.639-4.599, p<0.001), high GPS (GPS 0 vs 1-2: HR 2.016, 95%C.I. 1.233-3.296, p<0.001) were significantly associated with poor OS.
Conclusions
NLR may be better prognosticator than GPS for patients with metastatic or recurrent pancreatic cancer treated with FFX or GnP.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
H. Nakatsumi: Honoraria (self): Takeda; Honoraria (self): Sanofi; Honoraria (self): Merck Biopharma; Honoraria (self): Taiho Pharmaceutical; Honoraria (self): Ono Pharmaceutical. Y. Kawamoto: Honoraria (self): Taiho Pharmaceutical; Honoraria (self): Takeda; Honoraria (self): Chudai Pharma; Honoraria (self): Daiichi Sankyo; Honoraria (self): Merck; Honoraria (self): Lilly; Honoraria (self): Japan Agency for Medical Research and Development. S. Yuki: Honoraria (self): Takeda Pharmaceutical Co., Ltd.; Honoraria (self): Ono Pharmaceutical Co., Ltd.; Honoraria (self): Sanofi K.K.; Honoraria (self): Bayer Yakuin., Ltd.; Honoraria (self): Eli Lilly K.K.; Honoraria (self): Bristol-Myers Squibb Co., Ltd.; Honoraria (self): Merck Biopharma Co., Ltd.; Honoraria (self): Chudai Pharmaceutical Co., Ltd.; Honoraria (self): Taiho Pharmaceutical Co., Ltd.; Honoraria (self): Yakult Honsha Co., Ltd.; Honoraria (self): MSD K.K. N. Sakamoto: Honoraria (self): Gilead Sciences; Honoraria (self): Chudai Pharm; Honoraria (self): Bayer AG; Honoraria (self): Otsuka Pharm; Honoraria (self): Daiichi-Sankyo; Honoraria (self): Astellas Pharma; Honoraria (self): Takeda; Honoraria (self): Eisai; Research grant/Funding (self): Gilead Sciences; Research grant/Funding (self): Eisai; Research grant/Funding (self): MSD; Research grant/Funding (self): Otsuka Pharm; Research grant/Funding (self): AbbVie; Research grant/Funding (self): Asuka Pharm. Y. Komatsu: Research grant/Funding (institution): Eisai; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Daiichi-Sankyo; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Yakult; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Chugai; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Taiho; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Lilly; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Sanofi; Research grant/Funding (institution): MSD; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Ono; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Nipro; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Asahikasei; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Nihonkayaku; Honoraria (self), Speaker Bureau/Expert testimony, Research grant/Funding (institution): Takeda; Honoraria (self), Research grant/Funding (self): Bayer; Honoraria (self): Kyowa Kirin; Honoraria (self): Merck Biopharma; Honoraria (self): Bristol-Myers Squibb; Honoraria (self): Shire Japan; Honoraria (self): Novartis Pharma; Honoraria (self): Pfizer. All other authors have declared no conflicts of interest.
Resources from the same session
183P - Textbook outcome as a measure of surgical quality assessment and prognosis in gastric neuroendocrine carcinoma: A large multicenter sample analysis
Presenter: You-Xin Gao
Session: e-Poster Display Session
184P - Development and external validation of a nomogram to predict recurrence-free survival after R0 resection for stage II/III gastric adenocarcinoma: An international multicenter study
Presenter: Bin-Bin Xu
Session: e-Poster Display Session
185P - Effect of sarcopenia on short- and long-term outcomes of patients with gastric neuroendocrine tumour after radical surgery: Results from a large, two-institutional series
Presenter: Ling-Qian Wang
Session: e-Poster Display Session
186P - Characterization of the gastroenteropancreatic neuroendocrine tumour patient journey
Presenter: George Fisher Jr
Session: e-Poster Display Session
187P - More is not always better: A multicenter study in lymphadenectomy during gastrectomy for gastric neuroendocrine carcinoma
Presenter: Qi-Yue Chen
Session: e-Poster Display Session
188P - The impact of sarcopenia on chemotherapy toxicity and survival rate among pancreatic cancer patients who underwent chemotherapy: A systematic review and meta-analysis
Presenter: Billy Susanto
Session: e-Poster Display Session
190P - Outcomes from the Asian region of the phase III APACT trial of adjuvant nab-paclitaxel plus gemcitabine (nab-P/G) vs gemcitabine (G) alone for patients (pts) with resected pancreatic cancer (PC)
Presenter: Joon Oh Park
Session: e-Poster Display Session
191P - First-line liposomal irinotecan + 5 fluorouracil/leucovorin + oxaliplatin in patients with pancreatic ductal adenocarcinoma: Results from a phase I/II study
Presenter: Andrew Dean
Session: e-Poster Display Session
192P - A multicenter crossover analysis of first and second-line FOLFIRINOX or gemcitabine plus nab-paclitaxel administered to pancreatic cancer patients: Results from the NAPOLEON study
Presenter: Kenta Nio
Session: e-Poster Display Session
193P - First-line liposomal irinotecan + 5 fluorouracil/leucovorin + oxaliplatin in patients with pancreatic ductal adenocarcinoma: Exploratory survival analyses by change in post treatment CA 19-9
Presenter: Andrew Dean
Session: e-Poster Display Session