The Relationship Between GRIm Score and Prognosis in Patients with Metastatic Pancreatic Cancer

Authors : Anıl Yıldız, Gökmen Umut Erdem, Özde Melisa Celayir, Alperen Akansel Çağlar, Shamkhal Safarov, Tuğrul Burak Genç, Mehmet Fatih Özbay, Nilüfer Bulut

Pages : 671-679

View : 69 | Download : 128

Publication Date : 2026-01-01

Article Type : Research Paper

Abstract :Aims: The Gustave Roussy Immune (GRIm) score, integrating lactate dehydrogenase (LDH), albumin, and neutrophil-to-lymphocyte ratio (NLR), has emerged as a practical immune–nutritional index; however, evidence in metastatic pancreatic adenocarcinoma remains limited. This study aimed to evaluate the prognostic value of the GRIm score for progression-free survival (PFS) and overall survival (OS) in patients receiving systemic therapy. Methods: This retrospective study included 94 patients diagnosed with metastatic pancreatic cancer who received systemic therapy between 2020 and 2024. Baseline LDH, albumin, and neutrophil-to-lymphocyte ratio (NLR) were used to compute the GRIm score. One point was assigned for each adverse factor (elevated LDH, hypoalbuminemia, and increased NLR), yielding a total score ranging from 0 to 3; patients were then categorized as low (0–1) or high (2–3) GRIm. Results: The mean age was 59.9 ± 10.1 years and 59 patients were men (62.8%). GRIm score distribution was 0 in 33.0%, 1 in 42.6%, and 2–3 in 24.5%. Median follow-up was 9 months (range, 1–36); progression occurred in 74.5% and mortality in 84%. Median PFS was 5.0 months (IQR, 1.0–10.0). Outcomes deteriorated stepwise with increasing GRIm: median PFS was 9, 6, and 2 months for GRIm 0, 1, and 2–3, respectively (p<0.001), and median OS was 14, 10, and 4 months (p<0.001). In multivariable analyses, GRIm 2–3 independently predicted both progression (PFS: HR 3.64, 95% CI 1.95–6.82, p<0.001) and death (OS: HR 2.15, 95% CI 1.09–4.22, p=0.027) compared with GRIm 0, whereas GRIm 1 was not significant. Conclusion: A high GRIm score was associated with worse PFS and OS, independent of disease stage, metastatic burden, and treatment regimen. The GRIm score is a simple, practical prognostic biomarker in metastatic pancreatic cancer.
Keywords : pankreas kanseri, metastatic, GRIm skoru, progresyonsuz sağkalım, genel sağkalım

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