Use and outcomes of chemotherapy for metastatic pancreatic cancer in Australia
Journal Title
Internal Medicine Journal
Publication Type
Journal epub ahead of print
Abstract
BACKGROUND: Metastatic pancreatic ductal adenocarcinoma (mPDAC) is highly lethal. Combination chemotherapy regimens improve overall survival (OS). Historically, only one third of mPDAC patients in Victoria received chemotherapy ((1)) . AIM: To describe current Australian chemotherapy utilisation and outcomes in patients with mPDAC using the multi-site PURPLE (Pancreatic cancer: Understanding Routine Practice and Lifting End Results) registry. METHODS: PURPLE collects longitudinal data on consecutive patients with pancreatic cancer seen since January 2016. Data was collated for patients with mPDAC from six Victorian sites, and analysed descriptively. RESULTS: Three-hundred-and-sixty-three patients with mPDAC were identified. Median age was 70 years (20-94). First line chemotherapy was administered in 195 patients (54%). Prevalent regimens included gemcitabine-nab-paclitaxel (71%), gemcitabine alone (10%) and FOLFIRINOX (6%). Sixty-two of 195 (32%) patients who received first line treatment have proceeded to second line chemotherapy. Chemotherapy treated patients were younger (69 versus 73 years, p<0.01), with better ECOG performance status (ECOG 0-1 89% vs. 66%, p<0.01) and lower median Charlson comorbidity index (3 vs. 4, p<0.01) compared with untreated patients. Median OS of the entire cohort from diagnosis of metastases was 5.1 months. Median OS was 9.3 months in the chemotherapy treated patients, and 2.5 months in chemotherapy-untreated patients (p<0.01). CONCLUSIONS: A substantial proportion of patients with mPDAC still do not receive active treatment, which may in part by explained by age, poor performance status and comorbidity. Gemcitabine-nab-paclitaxel was the preferred first line chemotherapy regimen. Median OS for treated patients in this cohort was comparable to that of recent published clinical trials. This article is protected by copyright. All rights reserved.
Publisher
Wiley
WEHI Research Division(s)
Personalised Oncology
PubMed ID
33040452
Publisher's Version
https://doi.org/10.1111/imj.15094
Rights Notice
Refer to copyright notice on published article.


Creation Date: 2020-10-17 02:40:34
Last Modified: 2020-11-03 09:52:40
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