Prognostic value of the early change in neutrophil-to-lymphocyte ratio in metastatic pancreatic adenocarcinoma

• Published in: Clinics and research in hepatology and gastroenterology 2021-05, Vol.45 (3), p.101541-101541, Article 101541
• Main Authors: McLellan, Paul, Henriques, Julie, Ksontini, Feryel, Doat, Solène, Hammel, Pascal, Desrame, Jérome, Trouilloud, Isabelle, Louvet, Christophe, Pietrasz, Daniel, Vernerey, Dewi, Bachet, Jean-Baptiste
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - drug therapy; Biomarker; Biomarkers; Human health and pathology; Humans; Hépatology and Gastroenterology; Life Sciences; Lymphocytes; Metastatic pancreatic cancer; Neutrophil to lymphocyte ratio; Neutrophils; Pancreatic Neoplasms; Pancreatic Neoplasms - drug therapy; Prognosis; Prognostic; Prospective Studies; Retrospective Studies
• ISSN: 2210-7401; 2210-741X
• DOI: 10.1016/j.clinre.2020.08.016

•What is already known on this subject?○Neutrophils-to-lymphocytes ratio (NLR) at diagnosis is an independent prognosis marker in metastatic pancreatic cancer.•What are the new findings?•Early NLR change during chemotherapy has a prognostic value.•Overtime, patients with good prognosis have lower NLR values. •How might it impact on clinical practice in the foreseeable future?○A high NLR during chemotherapy and follow-up can be used by physicians as a severity indicator. In metastatic pancreatic adenocarcinoma, a high neutrophil-to-lymphocyte ratio (NLR) at diagnosis is a marker of poor prognosis. The prognostic role of baseline NLR and NLR change during first-line chemotherapy were determined. We conducted a retrospective study by using data from a single-center prospective cohort and a randomized open-label, multicenter, randomized trial. Two hundred and twelve patients were analyzed. Baseline NLR>5 was an independent marker of poor prognosis for overall survival (HR=2.01, 95% CI 1.33−3.05; P=0.001) and progression-free survival (PFS; HR=1.80, 95% CI 1.23–2.65; P=0.0026). According to NLR dynamics (n=172), patients with NLR≤5 on days 1 and 15 had a significantly better prognosis than those with NLR≤5 on day 1 and NLR>5 on day 15 (HR=2.23, 95% CI 1.18–4.21; P=0.013), NLR >5 on day 1 and NLR ≤5 on day 15 (HR=3.25, 95% CI 1.86–5.68; P5 on days 1 and 15 (HR=3.37, 95% CI 1.93–5.90; P5 in metastatic pancreatic cancer. The change in NLR early during chemotherapy was also a prognostic indicator in patients with NLR ≤5.