The lymphocyte to monocyte ratio in peripheral blood represents a novel prognostic marker in patients with pancreatic cancer

Stotz, Michael; Szkandera, Joanna; Stojaković, Tatjana; Seidel, Judy; Samonigg, Hellmut; Kornprat, Peter; Schaberl-Moser, Renate; Seggewies, F.; Höefler, Gerald; Gerger, Armin; Pichler, Martin

doi:10.1515/cclm-2014-0447

Cited by 72 publications

(58 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In another study, the lymphocyte/monocyte ratio was a good prognostic factor (13). Recently, several studies focused on the tumoural expression of the nucleoside transporter human equilibrative nucleoside transporter (hENT1) (10,11,14,15). A high expression of hENT1 seems to be associated with a greater efficacy of gemcitabine.…”

Section: Discussionmentioning

confidence: 99%

Locally Advanced or Metastatic Pancreatic Adenocarcinoma: Easily Available Factors of Predictive Prolonged Survival Under Gemcitabine

Ploquin

Truant²,

Piessen³

et al. 2017

View full text Add to dashboard Cite

7.7, 13.5, 19.7 and 21.0 months, respectively (p<0.001). Conclusion: We identified easily available prognostic factors for prolonged survival in patients treated with gemcitabine.Pancreatic adenocarcinoma (PA) is the fourth cause of cancer-related deaths (1). Surgical resection represents the only hope for cure but only 10-20% of patients present with a surgically-resectable tumour.For advanced and metastatic PA, systemic chemotherapy with single-agent nucleoside analogue gemcitabine is currently recommended as a standard in first-line treatment, with a significantly improved quality of life, and a median overall survival (OS) of 6-9 months (2). Although the absolute survival benefit remains poor and controversial, some patients (18%) survive more than 12 months (2). Gemcitabine chemotherapy has represented the single standard therapy for PA for more than a decade. Recently, a randomized trial compared gemcitabine and 5-fluorouracil/leucovorin/irinotecan/oxaliplatin combination (FOLFIRINOX) in front-line treatment of 342 patients with locally advanced or metastatic PA (3). The FOLFIRINOX regimen was superior to gemcitabine in terms of OS (11.1 vs. 6.8 months), progression-free survival (PFS) (6.4 vs. 3.3 months), and objective response rate (31.6 vs. 9.4%). Moreover, a recent update indicated that FOLFIRINOX was also superior in terms of quality of life (4). FOLFIRINOX is now the standard therapy in FRANCE. Yet FOLFIRINOX use is restricted to selected patients with preserved Eastern Cooperative Oncology Group performance status of 0-1, and with normal bilirubinemia. The toxicity of FOLFIRINOX is significant, especially in regard to the cumulative oxaliplatinrelated neurotoxicity. To avoid this toxicity, it would be useful to have easily available factors predictive of long survival with gemcitabine alone. The aim of the present study was to assess these potent predictive factors. Patients and MethodsPatients. We conducted a multicentric retrospective study between 1999 and 2010 at two centres in northern France before the advent of FOLFIRINOX (3). Inclusion criteria were: age >18 years; an histologically confirmed PA or a tumour radiologically suggestive of PA growing between two different computed tomographic (CT) scans or magnetic resonance imaging (MRI); locally advanced or metastatic tumor, and no previous chemotherapy.Gemcitabine was administered at 1,000 mg/m 2 intravenously over 30 minutes weekly for 7 weeks followed by a 1-week break. Subsequent cycles consisted of weekly administrations 3 weeks out of 4. Radiological evaluations by CT scan or MRI were repeated every 2 months. Gemcitabine was stopped if the patient presented 731

show abstract

Section: Discussionmentioning

confidence: 99%

Locally Advanced or Metastatic Pancreatic Adenocarcinoma: Easily Available Factors of Predictive Prolonged Survival Under Gemcitabine

Ploquin

Truant²,

Piessen³

et al. 2017

View full text Add to dashboard Cite

show abstract

“…This ratio reflects both lymphopenia, resulting from weak, insufficient immunologic reaction to the tumor (14) and high levels of monocytes and macrophages present in the tumor microenvironment that support cancer cell invasion, migration, intravasation, angiogenesis and even lead to a suppression of anti-tumor immune reaction (15,16 (17). A small number of studies analyzed the impact of LMR on OS and PFS in patients with pancreatic adenocarcinoma, most of which have studied the role of preoperative LMR as an independent prognostic factor for survival (7,18). For example, Li et al in his study analyzed a large cohort of patients who underwent curative resection for pancreatic adenocarcinoma and found a significant association of higher LMR with OS in univariate (19 vs. 12 months, P=0.000), and multivariate analysis (P=0.000) and with median recurrencefree survival in univariate (18 vs. 10 months, P=0.000) and multivariate analyses (HR: P=0.000) (7).…”

Section: Discussionmentioning

confidence: 99%

Does Lymphocyte-to-Monocyte Ratio Before, During, or After Definitive Chemoradiation for Locally Advanced Pancreatic Cancer Predict for Clinical Outcomes?

Scartoni

Giacomelli

Regine

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

Background: Elevated pre-treatment lymphocyte (L) to monocyte (M) ratio (LMR) in peripheral blood has been suggested to correlate with improved survival in some malignancies, but data in the context of pancreatic cancer (PC) is limited. The aim of this study was to evaluate the prognostic significance of LMR before, during and after definitive chemoradiotherapy (CRT) for locally advanced pancreatic cancer (LAPC). Conclusions: Factors significantly associated with overall survival (OS) and progression-free survival (PFS) were change in LMR at the end of CRT and absolute M count during CRT. This analysis suggests treatment-time-specific immune system parameters may affect clinical outcomes and warrant continued investigation.

show abstract

“…Peripheral blood cell count-derived ratios are, in essence, relative lymphocyte counts that may represent a form of liquid biopsy assessing the host immune response to the tumor although, as mentioned above, the difference between the local response in the tumor microenvironment and systemic response represents an obvious limitation here. However, lymphocyte counts expressed as ratios to neutrophil, platelet or monocyte counts have been shown, similarly to tumor-infiltrating lymphocytes, to predict prognosis across a wide range of neoplastic disorders [23,[33][34][35][36].…”

mentioning

confidence: 99%

Biomarkers, inflammation and cancer: where to go?

Melichar

2016

Clinical Chemistry and Laboratory Medicine (CCLM)

View full text Add to dashboard Cite

The lymphocyte to monocyte ratio in peripheral blood represents a novel prognostic marker in patients with pancreatic cancer

Abstract: In conclusion, we identified LMR as an independent prognostic factor in PC patients. Our results indicate that the LMR might represent a novel and useful marker for patient stratification in PC management.

Cited by 72 publications

References 49 publications

Locally Advanced or Metastatic Pancreatic Adenocarcinoma: Easily Available Factors of Predictive Prolonged Survival Under Gemcitabine

Locally Advanced or Metastatic Pancreatic Adenocarcinoma: Easily Available Factors of Predictive Prolonged Survival Under Gemcitabine

Does Lymphocyte-to-Monocyte Ratio Before, During, or After Definitive Chemoradiation for Locally Advanced Pancreatic Cancer Predict for Clinical Outcomes?

Biomarkers, inflammation and cancer: where to go?

Contact Info

Product

Resources

About