Abstract 153P
Background
The SIRI, defined by neutrophil x monocyte/lymphocyte 109/L, has emerged as a prognostic factor for pancreatic cancer. However, the association between SIRI after chemotherapy and tumor response has not been analysed.
Methods
161 metastatic pancreatic cancer patients were retrospectively analysed. Associations between overall survival (OS), chemotherapy, CA 199 and SIRI were evaluated. A larger number of patients with pre-treatment SIRI (pre-SIRI) were collected so, post-treatment SIRI (post-SIRI) evaluated after three cycles was adjusted for analysis.
Results
Median age 66 years. 36% received gemcitabine + nab-paclitaxel, 24% gemcitabine, 17% mFOLFIRINOX, 7% other regimens. 16% had not received treatment. Pre-SIRI≥2.3×109/L was an independent, negative predictor of OS compared to pre-SIRI<2.3×109/L [5 versus 16 months, Hazard Ratio 2.87, Confidence Interval 95% 2.02-4.07, P<0.0001]. Pre-CA199 showed no prognostic ability for OS (P=0.095). SIRI values increased after treatment (median pre-SIRI: 1.6×109/L; post-SIRI: 2.3×109/L; P=0.007). On the contrary, CA199 values decreased (574 versus 291 U/mL; P=0.008). Thus, we analyzed the association between tumor response measured by RECIST and pre-SIRI and post- SIRI values as well as pre-CA19-9 and post CA19-9. Patients with progressive disease (PD) showed a higher pre-SIRI than those who had a response to chemotherapy (2.7×109/L versus 1.2×109/L; P<0.001). Pre-CA199 was also higher in patients with PD, but not statistically significant (3089 versus 1021 U/mL; P=0.89). We observed a statistically significant increase in post-SIRI values for PD compared to tumor response (3.2×109/L versus 1.7×109/L; P=0.012). This was also observed for post-CA199 when PD and response values were compared (1021 versus 237; P=0.03). Post-SIRI≥2.3×109/L showed a shorter OS compared to post-SIRI<2.3×109/L (8 versus 17 months; P=0.016).
Conclusions
SIRI≥2.3×109/L was a prognostic factor for metastatic pancreatic cancer. An elevated post-SIRI associated with disease progression and had a negative impact on survival. A SIRI≥2.3×109/L could be related to high tumor burden and be useful to select patients who would benefit of intensive first-line chemotherapy.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
V.E. Pacheco-Barcia: Travel/Accommodation/Expenses: Roche; Travel/Accommodation/Expenses: Eisai; Travel/Accommodation/Expenses: MSD; Travel/Accommodation/Expenses: AstraZeneca; Travel/Accommodation/Expenses: Esteve ; Travel/Accommodation/Expenses: Bristol Myers Squibb; Travel/Accommodation/Expenses: Bayer ; Travel/Accommodation/Expenses: Leo Pharma. All other authors have declared no conflicts of interest.