Eosinophil-to-Lymphocyte Ratio Associated with Shorter Survival in Pancreatic Cancer

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Are systemic inflammatory biomarkers in the blood potential prognostic markers of overall survival in pancreatic cancer?
Are systemic inflammatory biomarkers in the blood potential prognostic markers of overall survival in pancreatic cancer?
The following article features coverage from the ESMO World Congress on Gastrointestinal Cancer 2018 meeting. Click here to read more of Cancer Therapy Advisor's conference coverage.

A low neutrophil-to-lymphocyte (NLR) or high eosinophil-to-lymphocyte ratio (ELR) was associated with prolonged overall survival (OS) in patients with locally advanced pancreatic cancer undergoing chemoradiotherapy, according to a study presented at the ESMO World Congress on Gastrointestinal Cancer 2018.1

NLR has been shown to be a prognostic marker for survival among patients with pancreatic cancer. This study aimed to evaluate eosinophils and the eosinophil-to-lymphocyte ratio as a potential prognostic marker in this population.

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The retrospective study included 57 consecutive patients diagnosed with locally advanced, stage I to III pancreatic cancer who underwent treatment with gemcitabine plus external beam radiotherapy (45 Gy) at a single institution. Immune cell counts were determined from blood samples collected at diagnosis. The cutoff values were determined to be 1.9 for NLR and 0.11 for ELR based on ROC curves.

At diagnosis, the median age was 66 years and 58% of patients were male. Most patients had stage IIB-30 disease (52.6%), followed by IIA-9 (15.8%), and III-8 (13.5%). The disease was primarily adenocarcinoma (77.2%) and located within the head of the pancreas (71.9%).

NLR greater than or equal to the cutoff was significantly associated with a shorter OS, with a median OS of 14.6 months (95% CI, 10.8-18.4 months) compared with 26.2 months (95% CI, 13.4-38.9 months) with a lower value (P = .033). Patients with an ELR at or above the cut-off value demonstrated a longer median OS of 21.4 months (95% CI, 11.0-31.7 months) compared with 15.6 months (95% CI, 11.5-19.7 months) with a lower ELR value (P = .067).

The authors stated that their results “could help identify patients with higher risk of progression, with the additional benefit that both NLR and ELR are inexpensive and easy to get from the pretreatment analysis.”

Read more of Cancer Therapy Advisor's coverage of the ESMO World Congress on Gastrointestinal Cancer 2018 meeting by visiting the conference page.


  1. Holub K, Conill C. The impact of inflammatory biomarkers on overall survival of patients with pancreatic cancer treated with chemoradiation. Ann Oncol. 2018;29 (suppl 5;abstr P-135):v29. doi: 10.1093/annonc/mdy151.134

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