Prognostic and predictive significance of inflammatory markers in patients with locally advanced unresectable and metastatic pancreatic cancer treated with first-line chemotherapy FOLFIRINOX or Gemcitabine/Nabpaclitaxel.

Abstract

Background: Advanced pancreatic ductal adenocarcinoma (PDAC) remains a disease with a dismal prognosis, significantly limited therapeutic options, and few innovative drugs. Inflammation plays a significant role in the development and progression of PDAC. Systemic inflammatory indexes reflect the anti-tumor inflammatory capacity of and are of prognostic and predictive value in the treatment of patients with PDAC.

Methods: In our retrospective study, we investigated the prognostic and predictive significance of inflammatory markers in chemonaive patients with locally advanced unresectable pancreatic cancer (LAPC) and metastatic pancreatic cancer (mPDAC), in relation to progression-free survival (PFS) and overall survival (OS). Survival analysis was conducted using the Kaplan-Meier method with log-rank tests in univariate analysis. We used multivariate Cox regression analysis to determine the impact of inflammatory markers on survival time.

Results: The present clinical study included 46 patients with LAPC and mPDAC treated with FOLFIRINOX (folinic acid, fluorouracil, irinotecan, oxaliplatin) or GEM/Nab-P (gemcitabine/nab-paclitaxel) as first-line chemotherapy regimens. Performance status (PS) ECOG 0-1, neutrophil-to-lymphocyte ratio (NLR)≤2.09 and the prognostic nutritional index (PNI)≥49.09 were associated with significantly longer OS in the analyzed patient cohort, Multivariate analysis confirmed PS, NLR and PNI as independent prognostic factors for OS.

Conclusion: In our cohort of patients with advanced PDAC, PS, NLR and PNI were confirmed as independent prognostic factors for OS (Tab. 9, Fig. 2, Ref. 82). Text in PDF www.elis.sk Keywords: pancreatic cancer, inflammatory markers, tumor microenvironment, chemotherapy.