The multicenter study included 672 patients treated with first-line chemotherapy. A low SIRI score (≤2.3) was associated with longer overall survival (14.0 vs. 9.2 months). It was also associated with longer progression-free survival (5.9 vs. 3.9 months) and a higher tumor response rate (37% vs. 25%). In addition to the classic cutoff point, the SIRI was analyzed as a continuous variable. This analysis revealed a nonlinear relationship between increasing SIRI and a worse prognosis. A high SIRI score was also associated with a higher hepatic tumor burden and cachexia.
An open-access web calculator allows users to explore this continuous prognostic gradient on an individualized basis: https://pantheia-siri.shinyapps.io/calc/.

The collaborative study was led by Vilma Pacheco-Barcia and has been published in the journals *Pancreatology* and *Clinical Translational Oncology*.

PMID 42601286, 42690293

doi: 10.1016/j.pan.2026.08.008

doi: 10.1007/s12094-026-04554-8