Comparison of Pancreatic Cancer Treatment Outcomes: A Real-World Data Analysis

Abstract

Background Since the ground-breaking phase III MPACT trial showed clear benefit of gemcitabine-nab-paclitaxel, this regimen has emerged as the standard of care for advanced pancreatic adenocarcinoma (PAC). Prior to this study, few studies have shown how results from randomized controlled trial translate to the real world. This study investigated how patients fared in the real world. Methods This single-centre, retrospective study was conducted in the Vaasa Central Hospital, Finland. 148 patients with PAC (ICD-10 C25) between 1/2011-12/2016 were identified with resectable, locally advanced or metastatic disease. Information about the basic characteristics, treatment regimens and adverse effects (AEs) were extracted from patient files and analysed. Results The median overall survival (OS) was 10.4 months for treated and 2.8 months for untreated patients. For metastatic disease OS was 4.9 months, for locally advanced 9.1 months. Patients who received 3 or more treatment lines had OS 19.1 months, while those who received 2 or 1 line had 11.3 and 6.2 months, respectively. The following grade 2–4 haematologic toxicities occurred: anaemia (n = 19), leukopenia (n = 49), neutropenia (n = 55) and thrombocytopenia (n = 9). Febrile neutropenia occurred 7 times. A total of 12 grade 5 AEs were recorded in 7 patients, and 3 other patients died of unknown complications. Conclusion This study shows that active treatment is worth pursuing in most PAC patients and study results from this real-world data study differ from randomized controlled trials. Special caution should be applied when continuing chemotherapy in patients with ECOG 2 and who are older than 70 years.