Abstract 258P
Background
Over the past seven years in Japan, targeted therapies based on comprehensive genomic profiling have been increasingly used for advanced pancreatic cancer (PC), and nanoliposomal irinotecan combined with fluorouracil/folinic acid (nal-IRI+5-FU/LV) has been approved as a second-line therapy. However, the impact of these novel treatments on the survival outcomes of all PC patients is not fully understood.
Methods
The main objective of this study was to investigate the treatment regimens and changes in overall survival (OS) for PC patients over the years. Patient data from our institution were reviewed retrospectively for the period between January 2017 and December 2023.
Results
A cumulative total of 2,540 treatments were administered to 1,607 patients with advanced PC. The median number of treatment lines was 1 (range, 1-6). A total of 1,379 patients (54.3%) received first-line treatment, and 836 patients (32.9%) received second-line therapy. Cumulatively, 220 patients (8.7%) received targeted or investigational therapy. The most widely used regimen as first-line treatment was gemcitabine plus nab-paclitaxel (GnP) (71.4%), followed by modified FOLFIRINOX (13.1%), and targeted or investigational therapy (6.4%). The most widely used regimens as second-line treatment were S-1 monotherapy (33.5%), GnP (19.3%), and nal-IRI+5-FU/LV (17.5%). The median OS for patients who received first-line treatment was 15.4 months, and there was no significant difference in OS between years (Table) Table: 258P
| Year | 2017 (n=184) | 2018 (n=200) | 2019 (n=154) | 2020 (n=202) | 2021 (n=196) | 2022 (n=228) | 2023 (n=215) |
| median overall survival, months∗ | 14.7 | 14.9 | 17.4 | 14.7 | 14.9 | 16.1 | 13.9 |
| (95% confidence interval) | (11.9-17.4) | (11.5-17.3) | (14.0-22.1) | (13.2-16.8) | (11.2-17.4) | (13.4-18.8) | (12.1-) |
| 1-year overall survival rate | 57.3% | 55.9% | 62.7% | 59.7% | 56.6% | 61.2% | 60.6% |
* log-rank p=0.851
.Conclusions
Despite the approval of novel treatments, their impact on the survival outcomes of all PC patients remains limited. In the treatment of PC, the difficulty in transitioning to second-line treatment and the lack of targeted therapy options may prevent significant improvement in prognosis.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
H. Imaoka: Financial Interests, Personal, Invited Speaker: Yakult Honsha, AstraZeneca, Nihon Servier, Kaneka Medix, SB KAWASUMI LABORATORIES, Boston Scientific, Novartis; Financial Interests, Personal, Advisory Board: Nihon Servier, Kaneka Medix; Financial Interests, Personal, Writing Engagement: Medico's Hirata; Financial Interests, Institutional, Local PI: Ono Pharmaceutical, Novartis, Nihon Servier. M. Ikeda: Financial Interests, Personal, Advisory Board: AstraZeneca, Chugai, Eisai, NIHON SERVIER, Novartis, Bristol Myers Squibb, MSD, Boehringer Ingelheim, Astellas Pharma, GSK; Financial Interests, Personal, Invited Speaker: AstraZeneca, Chugai, Eli Lilly Japan, Eisai, NIHON SERVIER, Novartis, Taiho, Yakult, Teijin Pharma, AbbVie, Fujifilm Toyama Chemical, Incyte Biosciences Japan, Takeda, Ono, MSD, Taisho Pharmaceutical, Nippon Kayaku, Guardant Health Japan, Nobelpharma, EA Pharma; Financial Interests, Institutional, Coordinating PI: Bayer, Bristol Myers Squibb, Eisai, AstraZeneca, Eli Lilly Japan, Chugai Pharmaceutical, MSD, Ono, Novartis, J-Pharma, Chiome Bioscience, NIHON SERVIER, Delta-Fly Pharma, Syneos Health, Merus.N.V., Merck biopharma, Boehringer Ingelheim, Invitae, Nobelpharma; Financial Interests, Personal, Steering Committee Member: Chugai, Nihon Servier, Takeda, Novartis, Eisai, Rakuten Medical. All other authors have declared no conflicts of interest.