Abstract 360P
Background
Prognostic Nutritional Index (PNI) has predominantly been explored in pre-surgical setting in patients with pancreatic cancer (PC). Systemic Immune-Inflammation Index (SII) has garnered attention as a prognostic tool in select carcinoma types. This study is centered on assessing the predictive validity of PNI and SII in the context of metastatic PC, hypothesizing their utility as pre-treatment biomarkers.
Methods
A single center retrospective analysis included patients with histologically confirmed diagnosis of metastatic PC. The key parameters analyzed were baseline lymphocyte (LC), neutrophil, thrombocyte counts, and serum albumin levels (SAL). PNI was derived using the formula: SAL (g/L) + 5 × LC (10ˆ9/L), stratifying patients into three cohorts based on PNI levels: <40, 40–45, and >45. SII was calculated as neutrophils × platelets / LC, dividing patients into two subgroups: SII below 600 and SII values below the cohort's median. The primary endpoint was to assess the influence on progression-free survival (PFS) and overall survival (OS), employing Kaplan-Meier survival analysis and Cox regression models.
Results
Overall, 121 patients were eligible for the analyses. The median PFS across the cohort was 3.47 months. A PNI <45 was associated with a markedly diminished PFS (2.83 months) compared to higher PNI levels (3.73 months; p<0.0195, HR 1.6164, 95% CI, range 1.08-2.42). Conversely, PNI <40 showed no significant impact on PFS. Moreover, SII values, both <600 and
Conclusions
These findings suggest that PNI could serve as a promising pre-treatment biomarker in metastatic PC, correlating with reduced PFS and poorer treatment outcomes. Based on these results, a prospective protocol has been developed to evaluate the independent prognostic value of PNI in systemic treatment-naive metastatic PC patients and to explore the potential correlation between PNI and SII with the expression of epigenetic regulators, including spatial transcriptomics.
Legal entity responsible for the study
Branislav Bystrický.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.