Abstract 374P
Background
Pancreatic cancer (PC) is a highly lethal malignancy and is still one of the leading causes of cancer-related death. Even after surgical resection the prognosis remains poor and the systemic treatment landscape has not changed much in recent years. Some studies demonstrated that neutrophil-to-lymphocyte ratio (NLR) can be considered an overall survival (OS) predictor in patients (pts) with PC, and the cut off of >5 demonstrated to be related with a worse median OS than those with ratios ≤5.
Methods
Retrospective analysis from PC pts between September 2018-September 2023 in our center, who received at least one cycle of systemic treatment. Our goal was to evaluate clinical and laboratory characteristics of PC pts, the treatment modalities and therapy sequencing. Survival curves were estimated with the Kaplan-Meier method.
Results
We collected data from 104 pts, with median age at diagnosis of 68.5 years old (40-85), 57.7% were male and 82.7% had Eastern Cooperative Oncology Group Performance Status 0-1. Regarding the tumor staging, 58 (55.8%) were diagnosed in stage IV. Median OS in our cohort was 12.0 months (95% CI: 8.8-15.2). From the pts with early-stage disease, 26 had surgery with curative intent and 24 of them performed chemotherapy (neoadjuvant or adjuvant). The most frequent metastatic site was the liver (49.0%). Regarding the first-line treatment, FOLFIRINOX was used in 31 pts, gemcitabine/nab-paclitaxel in 5 pts and Gemcitabine also in 31 of the 78 pts (39.7%). Median OS for pts treated with 1L FOLFIRINOX, gemcitabine/nab-paclitaxel and other treatments was 16.4 (95% CI: 7.8-25.0, p<0.001), 7.5 (95% CI: 0-16.4) and 4.4 (95% CI: 2.2-6.6) months, respectively. Median progression-free survival (mPFS) was also longer in the FOLFIRINOX group, 5.4 months (95% CI: 3.7-7.2). No statistical difference was found in pts with NLR below or higher than 5 (p=0.89).
Conclusions
Among metastatic PC pts receiving 1L treatment, FOLFIRINOX demonstrated the longest mOS (better than in the PRODRIGE trial, 16.4 vs. 11.1 months) and PFS (similar to this trial), confirming its efficacy as a standard first- line treatment. In our cohort the NLR (cut-off of 5) did not show significant predictive value for OS, contrasting with previous studies.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.