Patient characteristics, treatment patterns, and survival in a metastatic pancreatic adenocarcinoma US patient population.

Abstract

e16379 Background: Pancreatic adenocarcinoma (PDAC) is a leading cause of cancer-related deaths in the US. Clinical guidelines recommend first-line (1L) chemotherapy for patients with advanced or metastatic disease with an ECOG performance status < 3. Few studies have examined treatment patterns and real-world outcomes in patients diagnosed with PDAC. Methods: Medical and pharmacy claims data from the Healthcare Integrated Research Database (HIRD) were used to identify newly diagnosed patients with metastatic PDAC (mPDAC) who were ≥18 years of age with Commercial, Medicare Advantage, or Supplemental Medicare insurance in the US. The index date was the first mPDAC diagnosis, between January 1, 2020, and November 29, 2024. Patients were required to have ≥1 month of enrollment following their initial diagnosis or one day of enrollment if death occurred within one month of follow-up and had to initiate an mPDAC chemotherapy regimen within 90 days of diagnosis. Study follow-up continued through end of enrollment or death, whichever occurred first. Demographics, clinical characteristics, and PDAC treatment patterns were reported descriptively. Results: A total of 1911 patients with mPDAC initiated 1L chemotherapy and had a median follow-up of 6.3 months (range, 0.3-51 months). The average age was 65 years (range, 26-94 years), 57% were male, 68% were commercially insured (32% Medicare Advantage or Supplement), and mean Charlson Comorbidity Index was 3.6 (SD, 3.3). The most common 1L therapy was FOLFIRINOX (43%), followed by nab-paclitaxel + gemcitabine (26%) and FOLFOX (9%) (Table). In this population of patients with mPDAC receiving 1L chemotherapy, the median overall survival (mOS) was 6.3 months. Only 52% of patients who received 1L therapy started second-line (2L) chemotherapy, with nab-paclitaxel + gemcitabine being the most commonly used (27%). Similarly, only 53% of patients who initiated 2L therapy went on to third-line (3L) chemotherapy, with nab-paclitaxel + gemcitabine being the most commonly used (24%). Conclusions: Despite a relatively young mPDAC cohort, the mOS of 6.3 months observed in this real-world study was lower than that reported in prior 1L clinical trials with chemotherapy. Treatment options that improve OS and tolerability are urgently needed for patients with mPDAC. Treated patients with mPDAC (N=1911) mOS (IQR), months 6.3 (3.1-11.4) 1L treatment, n (%)FOLFIRINOXNab-paclitaxel + gemcitabineFOLFOX 1911 (100)820 (43)495 (26)174 (9) 2L treatment, n (% of those from 1L)Nab-paclitaxel + gemcitabineFOLFIRIFOLFIRINOX 1000 (52)270 (27)138 (14)109 (11)