Chen Y, et al. - Given that a link between carbohydrate antigen 19–9 (CA19–9) decrease during treatment and superior survival of pancreatic cancer has been reported in many studies but there is insufficient evidence to show the correlation of high platelet level with inferior survival in pancreatic cancer, therefore, researchers investigated if the link between CA19–9 reduction and survival correspond to different levels of platelet in metastatic pancreatic cancer. In advanced pancreatic cancer patients (n = 200), CA19–9 serum level and platelet level at baseline and following the second cycle of chemotherapy were recorded. They found that in cases with low platelet level, intermediate platelet level, and high platelet level, the estimated multivariable-adjusted hazard ratios per unit reduction of CA19–9 change was 0.45 [95% confidence interval (CI), 0.33 to 0.62], 0.74 (95% CI, 0.50 to 1.09), and 0.94 (95% CI, 0.74 to 1.10), respectively. A pronounced link of CA19–9 drop with superior pancreatic cancer survival was noted in patients with a low platelet level. The underlying mechanisms of CA19–9 implicated in platelet/tumor cell interaction could be supported by this revelation.