The Prognostic and Early Efficacy Prediction Value of Baseline C-Reactive Protein-Albumin-Lymphocyte (CALLY) Index in Advanced Pancreatic Cancer.

Purpose: In this retrospective study, we aimed to investigate the prognostic and early efficacy prediction value of baseline CALLY index in advanced pancreatic cancer. Patients and Methods: We analyzed the clinical and follow-up data of 252 metastatic pancreatic cancer patients diagnosed at Nanjing Gaochun People's Hospital from January 2019 to June 2024. The optimal cut-off for the CALLY index was determined by maximizing Youden's index (J = sensitivity + specificity - 1) through receiver operating characteristic (ROC) curve analysis. Early treatment efficacy was evaluated according to RECIST 1.1 criteria based on radiological assessments at 6~9 weeks after initiating first-line therapy. The effect of the CALLY index on survival and early efficacy in first-line treatment was analyzed using the Kaplan-Meier method and the Cox proportional hazards model. The CALLY index was calculated as: (Albumin × Lymphocyte)/(CRP × 104). Results: The cut-off value of the CALLY index for predicting survival was determined at 0.27. The area under the curve (AUC) was 0.725. With a cut-off value of 0.27, patients were divided into two groups: those with CALLY ≥0.27 and those with CALLY <0.27. The median overall survival was 12 and 5 months respectively (P < 0.01). CALLY Index ≥ 0.27 was associated with better survival outcomes. Cox regression analysis revealed that a low CALLY index (<0.27) was independent predictors of poor prognosis. CALLY index of 0.27 for predicting early efficacy in advanced pancreatic cancer patients with an area under the curve (AUC) of 0.73, and there was a statistically significant difference in early efficacy of first-line therapy between the high and low CALLY groups (P = 0.022). Conclusion: Our findings suggest that the baseline CALLY index is a promising predictive biomarker for early efficacy and prognosis of patients with Pancreatic cancer, though its reliability requires validation in multicenter prospective studies.