Abstract 1676P
Background
Pancreatic cancer has a poor prognosis compared to many other malignancies. This study evaluated the clinical outcomes of systemic chemotherapy (CMT) in patients with locally advanced and metastatic pancreatic ductal adenocarcinoma (LA/M-PDAC).
Methods
A retrospective, observational chart review was conducted on patients with LA/M-PDAC who underwent CMT between January 2012 and November 2022. The efficacy data (objective response rate [ORR], disease-control rate [DCR], progression-free survival [PFS], and overall survival [OS]) were evaluated and compared using Pearson’s chi-square tests, Kaplan–Meier plots, and log-rank tests.
Results
Out of the 998 patients diagnosed with LA/M-PDAC, 332 (33.3%) received systemic CMT. Among the treatment regimens used, gemcitabine (GEM) was administered most frequently (33.7% of cases). The next most commonly utilized therapies were (m)FOLFIRINOX and GEM plus capecitabine (GEMCAPE), accounting for 27.4% and 26.2% of cases, respectively. Platinum doublets (PlatD) were administered in 9.3% of cases. The ORRs and DCRs of the four regimens differed significantly (for GEM, GEMCAPE, (m)FOLFIRINOX, and PlatD, the ORRs were 4.5%, 10.3%, 23.1%, 19.4%, respectively, with P < 0.0001; the DCRs were 38.4%, 52.9%, 73.6%, and 54.8%, respectively, with P < 0.0001). Patients who received combination CMTs had significantly longer median PFSs than those who received GEM alone (PFS = 4.93 months for GEMCAPE, 9 months for (m)FOLFIRINOX, 9.43 months for PlatD, and 3.87 months for GEM). When comparing GEMCAPE with (m)FOLFIRINOX, the median PFS was significantly lower in the GEMCAPE group (PFS = 4.93 vs 9.0 months; HR = 0.53; P < 0.0001). However, no significant differences were observed in the median OS rates of the four regimens in a multivariate Cox proportional-hazards model analysis. The frequency of treatment-related grade 3 or 4 adverse events was higher in the (m)FOLFIRINOX group, followed by the GEMCAPE group.
Conclusions
This study revealed that FOLFIRINOX exhibited higher ORR, DCR, and PFS rates than GEM or GEMCAPE. Nevertheless, no survival advantage was detected in the FOLFIRINOX groups, suggesting the influence of subsequent therapies.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
K. Korphaisarn: Financial Interests, Personal, Invited Speaker: Roche, Amgen, AstraZeneca, MSD; Non-Financial Interests, Principal Investigator: MSD, Roche. All other authors have declared no conflicts of interest.
Resources from the same session
1634P - Extensive molecular profiling of KRAS wild-type versus KRAS mutant pancreatic ductal adenocarcinoma on 233 patients
Presenter: Jeanne Lena
Session: Poster session 22
1635P - Germline pathogenic variants of cancer predisposition genes in a multicentre Italian cohort of pancreatic ductal adenocarcinoma patients
Presenter: Giulia Orsi
Session: Poster session 22
1636P - Circulating tumor DNA (ctDNA) profile in patients (pts) with pancreatic cancer (PC): A multicenter experience and challenges for clinical application
Presenter: Francisco Muñoz i Carrillo
Session: Poster session 22
1637P - Early retention of KRAS mutations in cfDNA is an ominous sign for pancreatic cancer patients during chemotherapy: A prospective cohort study
Presenter: Chien-Jui Huang
Session: Poster session 22
1638P - The prognostic and predictive role of class III β-tubulin and hENT1 expression in patients with advanced pancreatic ductal adenocarcinoma
Presenter: Taha Koray Sahin
Session: Poster session 22
1639P - Feasibility of tumor genomic sequencing on tissue obtained from endoscopic ultrasound in patients with pancreatic cancer
Presenter: Vaia Florou
Session: Poster session 22
1640P - Response monitoring with ctDNA in metastatic pancreatic cancer
Presenter: Jinwoo Ahn
Session: Poster session 22
1642P - Prognostic impact of an immunomorphological signature integrating immune, fibroblastic and tumor markers in a series of 217 resected pancreatic adenocarcinoma patients
Presenter: Franck MONNIEN
Session: Poster session 22
1643P - Clinical outcomes of FOLFIRINOX as front-line therapy in patients with localized pancreatic adenocarcinoma: Asian retrospective study of 781 patients
Presenter: Kyunghye Bang
Session: Poster session 22