Prognostic value of alkaline phosphatase and gamma-glutamyl transferase in patients with metastatic pancreatic cancer

Future Oncol. 2023 Apr;19(13):937-946. doi: 10.2217/fon-2023-0137. Epub 2023 May 26.

Abstract

Background: Pancreatic cancer (PC) is one of the most lethal malignancies worldwide. This study evaluated the prognostic role of serum alanine phosphatase (ALP) and gamma-glutamyl-transferase (GGT) in metastatic PC patients. Materials & methods: 153 patients with metastatic PC receiving first-line treatment with nab-paclitaxel/gemcitabine were retrospectively enrolled in a multicenter study and stratified according to ALP (≤ or >260 U/l) and GGT (≤ or >45.5 U/l) levels. Results: Improved overall survival was recorded in patients with GGT levels ≤45.5 U/l (p < 0.05). In patients with liver metastasis, overall survival was significantly lower in patients with high ALP (p = 0.01) and GGT (p = 0.02). Conclusion: High levels of ALP and GGT were related to a poor prognosis in PC patients with liver metastasis receiving nab-paclitaxel/gemcitabine.

Keywords: alkaline phosphatase; gamma-glutamyl transferase; metastatic pancreatic cancer; nab-paclitaxel plus gemcitabine; prognostic factors.

Plain language summary

Pancreatic cancer is a deadly form of cancer. This study looked at whether levels of two enzymes, alanine phosphatase (ALP) and gamma-glutamyl-transferase (GGT), in the blood of patients with metastatic pancreatic cancer could predict how long they would live. The study included 153 patients who were receiving their first treatment for metastatic pancreatic cancer. The patients were divided into groups based on whether their ALP and GGT levels were high or low. The researchers found that patients with low GGT levels tended to live longer. Patients with liver metastasis (spread of cancer to the liver) who had high levels of ALP and GGT tended to have a worse prognosis than patients with low levels of these enzymes. Therefore, higher levels of ALP and GGT in the blood may be associated with a poor prognosis in pancreatic cancer patients with liver metastasis who are receiving nab-paclitaxel/gemcitabine treatment.

Publication types

  • Multicenter Study

MeSH terms

  • Alkaline Phosphatase
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Gemcitabine
  • Humans
  • Liver Neoplasms*
  • Paclitaxel / therapeutic use
  • Pancreatic Neoplasms* / pathology
  • Prognosis
  • Retrospective Studies
  • gamma-Glutamyltransferase / blood

Substances

  • Alkaline Phosphatase
  • gamma-Glutamyltransferase
  • Gemcitabine
  • Paclitaxel