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Systemic inflammation adversely affects response to anamorelin in patients with pancreatic cancer

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Abstract

Purpose

Anamorelin, a selective ghrelin receptor agonist, has been approved for pancreatic cancer treatment in Japan. We aimed to investigate whether systemic inflammation, represented by the neutrophil–lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), and C-reactive protein (CRP)-albumin ratio (CAR), could predict the effect of anamorelin in patients with advanced pancreatic cancer.

Methods

This study included 31 patients who had received anamorelin for advanced pancreatic cancer between 2021 and 2023. Patients’ NLR, PLR, LMR, and CAR were evaluated before anamorelin administration. The patients were classified as responders and non-responders based on whether they gained body weight after 3 months of anamorelin administration. We investigated the association between systemic inflammation and anamorelin efficacy using a univariate analysis.

Results

Twelve (39%) patients were non-responders. A high serum CRP level (p = 0.007) and high CAR (p = 0.013) was associated with non-response to anamorelin. According to the receiver operating characteristics analysis, the CAR cutoff value was 0.06, and CAR ≥ 0.06 was a risk factor (odds ratio, 5.6 [95% confidence interval 1.2–27.1], p = 0.032) for non-response to anamorelin.

Conclusion

CAR can be a predictor of non-response to anamorelin in patients with advanced pancreatic cancer, suggesting the importance of a comprehensive assessment of the inflammatory status.

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Data availability

The data in this article is available from the corresponding author upon reasonable request.

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Funding

This work was supported by JSPS KAKENHI grant numbers JP22K16453 (to M.T.), 21K08806 (to T. U.), JP21K08718 (to T. I.), and JP21K08805 (to K. H.), and by a research grant from the Princess Takamatsu Cancer Research Fund (to T.I.).

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Authors and Affiliations

  1. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan

    Masashi Tsunematsu, Tadashi Uwagawa, Shinji Onda, Yoshihiro Shirai, Norimitsu Okui, Michinori Matsumoto, Kenei Furukawa, Koichiro Haruki, Shunta Ishizaki & Toru Ikegami

Authors
  1. Masashi Tsunematsu
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  2. Tadashi Uwagawa
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  3. Shinji Onda
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  4. Yoshihiro Shirai
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  5. Norimitsu Okui
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  6. Michinori Matsumoto
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  7. Kenei Furukawa
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  8. Koichiro Haruki
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  9. Shunta Ishizaki
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  10. Toru Ikegami
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Contributions

Masashi Tsunematsu: Study design, data collection and analysis, and manuscript drafting. Tadashi Uwagawa: Data collection and manuscript revision. Shinji Onda: Data collection. Yoshihiro Shirai: Data collection. Norimitsu Okui: Data collection. Michinori Matsumoto: Data collection. Kenei Furukawa: Data collection. Koichiro Haruki: Data collection. Shunta Ishizaki: Data collection. Toru Ikegami: Manuscript revision and final approval.

Corresponding author

Correspondence to Masashi Tsunematsu.

Ethics declarations

Ethics approval

This study was approved by the institutional Ethics Committee of The Jikei University School of Medicine [27–177(8062)] and conforms to the provisions of the Declaration of Helsinki, as revised in Fortaleza, Brazil in October 2013.

Consent to participate

Informed consent was obtained from all patients by the opt-out method.

Competing interests

The authors declare no competing interests.

Conflicts of interest

The authors declare no conflicts of interest in association with the present study.

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Tsunematsu, M., Uwagawa, T., Onda, S. et al. Systemic inflammation adversely affects response to anamorelin in patients with pancreatic cancer. Support Care Cancer 31, 732 (2023). https://doi.org/10.1007/s00520-023-08206-3

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