Glycemic Control as an Early Prognostic Marker in Advanced Pancreatic Cancer

Area of Science:

• Oncology
• Metabolic Research
• Clinical Biomarkers

Background:

• Most patients with pancreatic ductal adenocarcinoma (PDAC) exhibit impaired glucose metabolism.
• Previous research focused on pre-treatment glycemic indices and prognosis in diabetic patients.
• The impact of glycemic control during chemotherapy on survival in PDAC patients (with or without diabetes) remains understudied.

Purpose of the Study:

• To investigate the relationship between early glycemic control and overall survival (OS) in advanced PDAC patients.
• To assess prognostic value of glycemic control during chemotherapy in a community-based setting.

Main Methods:

• Seventy-three advanced PDAC patients (38% with diabetes) receiving chemotherapy were included.
• Clinical data and laboratory results, including random blood glucose (RBG), were collected over one year.
• Kaplan-Meier, log-rank tests, and Cox proportional hazards regression were used to analyze the effect of glycemic control on OS.

Main Results:

• Analysis of 1,418 random blood glucose (RBG) values revealed significant findings.
• An elevated 3-month average RBG (RBG-3) was associated with longer survival in univariate analysis.
• Multivariate analysis confirmed that RBG-3 ≤120 mg/dl predicted improved OS (19 vs. 9 months; HR=0.37, P=0.002), regardless of diabetes status.

Conclusions:

• Lower glucose levels within the first three months of advanced PDAC treatment predict improved overall survival.
• The 3-month average RBG (RBG-3) may serve as a novel prognostic biomarker for PDAC.
• Further studies are warranted to confirm these findings in larger cohorts and explore causality.