Abstract 3680: Prognostic value of serum biomarkers in pancreatic adenocarcinoma: Results from a Swiss single center cohort analysis
Authors: Chiru Elena D. , Knufike Marie , Sonderegger-Stalder Martina , Mosimann Raphael , Sgries Antonia , Rosenberg Robert , Burri Emanuel , Mitrovic Sandra , Voegeli Michèle , Mertz Kristen , Angelini Alessandra , Vetter Marcus 
Published: March 2024

Introduction: Inflammatory and nutritional biomarkers, such as neutrophil to lymphocyte ratio (NLR), C-Reactive Protein (CRP), lactate dehydrogenase (LDH) and albumin, are valuable prognostic indicators, refining stratification strategies in oncological patients. This study aims to delineate the impact of these markers on overall survival in patients with pancreatic adenocarcinoma, in order to aid in clinical risk stratification.

Methods: We conducted a retrospective analysis on patients with adenocarcinoma of the pancreas, treated at the Cantonal Hospital Baselland (January 2018 - February 2022). Clinical data, including diagnosis, treatment, and blood markers, were extracted from electronic records. The analysis incorporated the computation of median values for each blood marker, followed by survival analysis and determination of Cox proportional hazard ratios with a 95% confidence interval.

Results: Our cohort included 43 patients, 53% women, 44% men, median age 73 years (IQR 14.75) with adenocarcinoma of the pancreas. Most patients (56%) had advanced distant disease and 25% of these did not receive any oncological therapy. At least one cycle of chemotherapy was administered in 85% of patients. NLR&lt;4 was reported in 63% of cases, normal albumin levels in 72%, normal LDH levels in 79%, and normal CRP levels in 47%. In the multivariate Cox regression analysis, there was a significant higher risk for death with metastatic disease (HR 6.216 CI 2.00-19.28, p=0.002), age ≥75 (HR 4.88, CI 1.65-14.39, p=0.004) and CRP&gt;10 (HR 3.38, CI 1.18-9.66, p=0.023) and lower risk with addition of chemotherapy (HR 0.076, CI 0.02-0.29, p&lt;0.001). NLR, LDH and albumin levels did not significantly correlate with higher HR for death. At a median follow-up period of 8.5 months (IQR 14), the median overall survival was 9 months (IQR 14.5) with a worsening prognostic for increased CRP (p=0.00027), NLR&gt;4 (p=0.051), albumin &lt;35g/l (p=0.0024), LDH &gt;250 U/l (p=0.037). Better survival rates were seen in patients receiving chemotherapy 75% vs 20 for those without chemotherapy (p&lt;0.0001) and in those with local disease 80% vs 60% for metastatic disease p=0.034). Age ≥75 years carried a significant poorer prognostic (p=0.0017), while gender was not relevant. However, due to small sample size, age adjusted survival was not carried out and age was considered not relevant for the survival analysis.

Conclusion: Beyond the expected factors like stage of disease and therapy, an increased CRP appears to carry significant correlation with hazard ratio for death among patients with adenocarcinoma of the pancreas. In our cohort, abnormal CRP, NLR, albumin and LDH levels demonstrated significant association with shorter survival period, underscoring the potential utility of these biomarkers in prognostic stratification and their incorporation into routine oncological assessments.

Citation Format: Elena D. Chiru, Marie Knufike, Martina Sonderegger-Stalder, Raphael Mosimann, Antonia Sgries, Robert Rosenberg, Emanuel Burri, Sandra Mitrovic, Michèle Voegeli, Kristen Mertz, Alessandra Angelini, Marcus Vetter. Prognostic value of serum biomarkers in pancreatic adenocarcinoma: Results from a Swiss single center cohort analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3680.