Derived neutrophil/lymphocyte ratio predicts gemcitabine therapy outcome in unresectable pancreatic cancer

Abstract

Abstract.As gemcitabine is a key anti-tumor agent for unresectable pancreatic ductal adenocarcinoma (PDAC), it is important to predict the outcomes of gemcitabine chemotherapy. The present study aimed to confirm whether the derived neutrophil-to-lymphocyte ratio (dNLR) is able to predict chemotherapy outcomes. To elucidate the role of dNLR in patients that underwent chemotherapy, the current study evaluated clinicopathological variables in 31 patients with unresectable PDAC treated with gemcitabine. The correlation between clinicopathological variables, and progression-free survival (PFS) and overall survival (OS) time were investigated. Univariate analysis revealed that there were no significant differences in PFS and OS as a function of age (<65 vs. ≥65 years), gender, tumor location (pancreas head vs. body/tail), tumor diameter (<23 vs. ≥23 mm) or serum carbohydrate antigen 19-9 concentration level (<3,800 vs. ≥3,800 U/ml). However, disease stage (locally advanced vs. metastatic) and the dNLR (<2.5 vs. ≥2.5) significantly affected PFS and OS. Multivariate analysis subsequently revealed that a dNLR of ≥2.5 was an independent prognostic factor for poor PFS (P=0.003) and OS (P=0.026). In conclusion, data from the present study suggests that the pre-treatment dNLR is an independent prognostic factor to predict PFS and OS in patients with unresectable PDAC treated with gemcitabine. This indicates that dNLR has a potential role in stratifying patients that may benefit from gemcitabine therapy.

Evaluation of inflammation‑based markers for predicting the prognosis of unresectable pancreatic ductal adenocarcinoma treated with chemotherapy

“…In patients with resectable PDAC, preoperative NLR (15), PLR (16,17), GPS (18) and PNI 45 (7) were reported to be factors in early recurrence and poor prognosis after surgical resection. In unresectable PDAC, previous reports showed that patients with a high NLR had a shorter OS time (13,19). In terms of GPS, a retrospective study Table III.…”

“…1. We previously reported that NLR is useful for predicting the outcome of gemcitabine therapy in unresectable PDAC (13). However,…”

Prognostic value of pretreatment inflammatory biomarkers in advanced lung adenocarcinoma patients receiving first-line pemetrexed/platinum doublet

“…26,27 These might partially explain why an elevated NLR is associated with poor survival. Recent clinical studies revealed that dNLR was associated with chemotherapy response 10,28 and prognosis in many advanced cancers, such as metastatic melanoma, 8 metastatic castration-resistant prostate cancer, 9 advanced biliary cancer, 10 and advanced colorectal cancer. 29 The dNLR is composed of WBCs and neutrophils; this parameter has been proposed as an alternative to NLR for studies where only WBCs and neutrophils have been recorded.…”

Neutrophil‐to‐lymphocyte ratio as a prognostic indicator in head and neck cancer: A systematic review and meta‐analysis

“…The PRISMA flow chart of the systematic review can be found in Figure . An initial search done using the search strategy (Supporting Materials) obtained an initial 900 results.…”