1668P - Prevalence and management of pancreatic ductal adenocarcinoma (PDAC) over a decade in France: A population-based study

Background

Significant progress has been made in the management of PDAC in recent years, with the development of new chemotherapy regimens validated in both adjuvant and metastatic settings, as well as neoadjuvant/induction therapy (N/IT). In this population-based study, we aimed to compare prevalence, therapeutic strategies, and survival outcomes of PDAC patients in France over a decade encompassing these advances.

Methods

This study was performed on SNDS (Système National des Données de Santé) data, including nationwide French data on the consumption of medical care. All patients managed for PDAC during years 2009, 2014 and 2018 were included. Treatment modalities and survival outcomes were analyzed.

Results

A total of 8143/10267/12089 patients were included during years 2009/2014/2018, respectively. Prevalence increased mainly among patients aged 60-75 (62% over the study period) and >75 (53%) while a lesser trend was seen in patients <60 (13%). In localized PDAC, the proportion of patients receiving best supportive care (BSC) decreased at 43.6/37.7/33.5%. More patients received chemotherapy +/- radiotherapy alone over time (27.8/28.5/33.4%), and surgical resection after N/IT increased at 0.9/2.5/5.5%. The rate of upfront surgery remained stable at about 28%. Among metastatic patients, 45.0/49.2/51.3% received BSC. In the overall population, no relevant difference in survival outcomes were seen over time, but median overall survival (OS) and 1-year OS improved significantly both in localized patients and treated metastatic patients (Table). The 1-year OS was 85.7/85.9/91.7% among patients receiving N/IT before surgery, vs 76.3/79.0/80.0% for upfront resection. Table: 1668P

Survival outcomes

Conclusions

This study confirms an increase in the prevalence of PDAC in France. Improved survival outcomes were seen in localized PDAC, with a wider use of chemotherapy and an increase in neo-adjuvant/induction strategies, and in treated metastatic patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

ACOBIOM.

Funding

ACOBIOM.

Disclosure

L. Mas: Financial Interests, Personal, financially compensated role: Merck. J. Bachet: Financial Interests, Personal, Advisory Role: Amgen, AstraZeneca, Bayer, BMS, GSK, Merck, MSD, Pierre Fabre, Roche, Sanofi, Servier; Financial Interests, Personal, Non-financial benefits: Amgen, Merck, Roche, Servier. All other authors have declared no conflicts of interest.