A systemic inflammation response index (SIRI) correlates with survival and predicts oncological outcome for mFOLFIRINOX therapy in metastatic pancreatic cancer |
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| Affiliation: | 1. Medical Oncology, Hospital Universitario La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid, Spain;2. Medical Oncology, McGill University Health Centre, Montreal, Canada;3. Surgical Oncology, McGill University Health Centre, Montreal, Canada;4. Surgical Oncology, Hospital Universitario La Princesa, Madrid, Spain;1. Department of Pancreatic Surgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China;2. Department of Surgery, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200032, China;1. Department of Gastroenterology, Changhai Hospital of Second Military Medical University, 168 Changhai Road, Shanghai, 200433, China;2. Department of Gastroenterology, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215008, China;3. Department of Pathology, Changhai Hospital of Second Military Medical University, 168 Changhai Road, Shanghai, 200433, China;1. Center for Exocrine Disorders, Department of Molecular and Cell Biology, Boston University, Henry M. Goldman School of Dental Medicine, Boston, MA, 02118, USA;2. Department of Surgery, University of California Los Angeles, Los Angeles, CA, 90095, USA;1. Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan;2. Department of Hepatobiliary and Pancreatic Oncology, Osaka International Cancer Institute, Osaka, Japan;1. Departement of Surgery, Institut Paoli-Calmettes, Marseille, France;2. Departement of Oncology, Institut Paoli-Calmettes, Marseille, France;3. Departement of Pathology, Institut Paoli-Calmettes, Marseille, France;4. Departement of Endoscopy, Institut Paoli-Calmettes, Marseille, France;5. Departement of Surgery, Aix-Marseille University, Institut Paoli-Calmettes, CRCM, Marseille, France |
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| Abstract: | ObjectivesSystemic inflammatory response and survival has not been evaluated as a predictive factor of chemotherapy in metastatic pancreatic cancer. The aim of this study was to evaluate the prognostic and predictive value of a baseline Systemic Inflammation Response Index (SIRI) in metastatic pancreatic cancer.MethodsRetrospective study of 164 metastatic pancreatic cancer patients. Associations between overall survival (OS), progression free survival (PFS), chemotherapy and SIRI were analyzed. SIRI is defined by neutrophil x monocyte/lymphocyte 109/L.ResultsMedian age 66 years. 22 (13%) received mFOLFIRINOX, 59 (36%) gemcitabine + nab-paclitaxel, 40 (24%) gemcitabine, 13 (8%) other regimens and 30 (18%) had not received treatment. Patients with SIRI<2.3 × 109/L showed a statistically significant improvement in OS compared to SIRI≥2.3 × 109/L [16 months versus 4.8 months, Hazard Ratio (HR) 2.87, Confidence Interval (CI) 95% 2.02–4.07, p < 0.0001] that was confirmed in multivariate analysis. In addition, patients with SIRI<2.3 × 109 showed a longer PFS (12 versus 6 months, HR 1.92, IC 95% 1.314–2.800, P = 0.001). Furthermore, we observed that patients with SIRI ≥2.3 × 109/L were more likely to benefit from mFOLFIRINOX therapy. Patients with an elevated SIRI treated with mFOLFIRINOX versus gemcitabine plus nab-paclitaxel and gemcitabine showed a clinically and statistically significant difference in median OS of 17 months compared to 6 and 4 months respectively (p < 0.001). Conversely, the difference was not clinically significant in the SIRI<2.3 × 109/L subgroup: 15.9 months versus 16.5 and 16, respectively.ConclusionAn elevated SIRI (≥2.3 × 109/L) was an independent prognostic factor for patients with metastatic pancreatic cancer, warranting prospective evaluation. |
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| Keywords: | Metastatic pancreatic cancer Systemic inflammation Biomarkers Prognostic factors Predictive factors |
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