755PPrognostic value of neutrophil-lymphocyte ratio in first line treatment for metastatic pancreatic adenocarcinoma

Background: Tumor location and pro-inflammatory microenvironment are both implicated in cancer progression and thus measures of these are thought to have important prognostic value. In this study, these readily available factors were examined in patients diagnosed with metastatic pancreatic adenocarcinoma (mPC) being treated in first line with FOLFIRINOX (FFX) or Gemcitabine with nab-Paclitaxol (GNP). Methods: A cohort of 75 patients diagnosed with mPC between 2010 – 2016 and treated either with FFX or GNP first line were analyzed. The NLR was calculated based on the complete blood count obtained on the day of the first treatment. Cox proportional hazard models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) associating progression free survival to the patients’ demographics, treatment, clinical and pathological factors. NLR was treated as a continuous covariate. Results: Of the total patients (60% male, median age 69), 44 (58.7%) were treated with FFX. At the time of diagnosis, 20 (26.6%) presented with ECOG 0, 43 (57.3%) with primary disease at the head of the pancreas and 25 (33.3%) with liver metastasis. Median NLR at the diagnosis was 5.35 (range 0.9 – 28.3). Increasing NLR was a significant prognostic factor for shorter PFS using a univariate model (HR 1.08, CI: 1.009 – 1.15, P = 0.026). In a multivariate model, significant prognostic factors associated with shorter PFS included primary disease location at the pancreatic tail/body (HR 1.92, CI: 1.009 – 3.664, p = 0.047) and higher NLR (HR 1.11, CI: 1.038-1.189, P = 0.002). Conclusions: Understanding the prognostic value of pro-inflammatory status and tumor location can allow clinicians to better manage the trajectory of patients with mPC. Legal entity responsible for the study: Lady Davis Institute and Segal Cancer Centre - Jewish General Hospital Funding: None Disclosure: All authors have declared no conflicts of interest.