Circulating calprotectin, innate inflammatory protein, was decreased under disease control during first-line chemotherapy for advanced pancreatic cancer.

Abstract

218 Background: There is increasing evidence of a close link between inflammation and disease control in pancreatic ductal adenocarcinoma (PDAC). Damaged-associated molecular patterns (DAMPs) were inducers of inflammation in the innate immune system and were detected in PDAC tissue in recent reports. Calprotectin, one of DAMPs, is recognized as a potential mediator of the process of disease control in various tumors. In this study, circulating calprotectin is characterized on disease control in patients with 1st line chemotherapy for advanced PDAC. Methods: Patients with treatment-naïve advanced PDAC were enrolled in this study. Patients with obvious infectious conditions were excluded. Serum levels of calprotectin and pro-inflammatory cytokines including interleukin-6 (IL-6) were measured at baseline and at one or two months later after the start of 1st line chemotherapy. Disease control rate (DCR) was evaluated on the Response Evaluation Criteria in Solid Tumors ver. 1.1. Results: A total of 73 patients were evaluated. DCRs of gemcitabine group (GEM) (n = 57) and the patients with modified FOLFIRINOX or GEM + nab-paclitaxel (mFFX/GN) (n = 16) were 52.6% and 75.0%,respectively. In comparison of baseline-and-after data, circulating calprotectin levels were significantly decreased under disease control in GEM (baseline vs. after: 2.9 vs. 2.3 ng/ml in median, p = 0.084) and GN/mFFX (2.7 vs. 0.5 ng/ml, p = 0.024. IL-6 was decreased in GN/mFFX (9.1 vs. 5.9 pg/ml; p= 0.095) but not in GEM (4.3 vs. 3.1 pg/ml; p = 0.303). There were no obvious changes under non-disease control in calprotectin (baseline vs. after: 6.2 vs. 5.9 ng/ml in GEM, 5.1 vs. 4.5 ng/ml in mFFX/GN) and IL-6 (16.5 vs. 25.6 pg/ml in GEM, 3.1 vs. 4.7 pg/ml in mFFX/GN). Conclusions: DCR relateda decrease of circulating calprotectin levelduring 1st line chemotherapy for advanced PDAC. Innate immune system plays a role in the chemotherapeutic efficacy in advanced PDAC.