1671P - Treatment patterns and efficacy in patients (pt) with pancreatic cancer (PC) from the Spanish RETUD registry

Background

Pancreatic carcinoma (PC) remains one of the deadliest cancers, with late detection and a complex, still unknown biology as the main factors driving its lethality. Chemotherapy and surgery are the primary options for PC, however, only 15-20% are eligible for surgery and two thirds relapse after. Novel diagnostic strategies are an urgent need for an earlier diagnosis, particularly in pt at higher risk for PC. We aimed to characterize real-world pt management for PC and the prevalence of molecular profiling in routine oncology practice.

Methods

A retrospective chart review of pt from the Spanish RETUD registry diagnosed with PC between 1 January 2019 and 31 December 2022 was conducted. Demographic, clinical characteristics, molecular profiling, systemic treatments, and outcomes were described.

Results

The registry included 1,438 evaluable pt. The median age was 66.8 years, 55.4% were men. Cancer family history was reported in 53.1% of pt. Main histology was ductal adenocarcinoma (97.8%). It was located in the head (59.5%) or body/tail (39.4%). Overall, 56.1%,19.0%,18.5% and 6.5% pt were diagnosed metastatic (met) locally advanced (LA), resectable and borderline PC respectively. Only 24.1% of pt underwent pancreatic surgery. Germline molecular analysis was performed in 135 pt where 17.8% had BRCA1 or BRCA2 mutations. KRAS mutation in tissue was assessed in 264 pt, and it tested positive in 68.9%. Most (70.2%) pt received first-line systemic treatment, mainly the gemcitabine-based combination NabPGEM (65.9%) or FOLFIRINOX (26.0%). At the database cut-off, 81.3% pt died. Median overall survival (OS) was 24.3 (95% confidence interval [95CI] 20.3-28.7), 13.4 (95CI 12.1-15.0) and 6.4 (95CI 5.7-7.3) months (m), for resectable, LA and met setting, respectively. Met PC median OS was 11.3 m (95CI 10.0-12.3) when treated with frontline NabPGEM and 13.1 m (95CI 11.5-16.5) with FOLFIRINOX (p=0.01).

Conclusions

Our study provides an overview of routinely recommended treatments and their effectiveness in a large multicenter real-world cohort of PC in Spain. Our findings suggest that FOLFIRINOX improves clinical outcomes of pt with met disease, when compared to NabPGEM. Molecular assessment must be enhanced at diagnosis in our environment.

Clinical trial identification

Editorial acknowledgement

Medical writing assistance was provided by Carla Martín Cortázar from Evidenze Health España S.L. during the preparation of this abstract.

Legal entity responsible for the study

This study has been promoted by the Spanish Group of Digestive Tumour Treatment (TTD).

Funding

AstraZeneca.

Disclosure

T. Macarulla: Financial Interests, Personal, Advisory Board: Ability Pharmaceutical, SL, AstraZeneca, Basilea Pharma, Batxer, BioLineRX Ltd, Celgene SLU, Eisai, IPSEN Pharma, Incyte; Financial Interests, Personal, Other, Direct research fund: Servier, Merck, Sharp and Dhome, Novocure, QED Therapeutics Inc, Roche, Sanofi-Aventis, Zymeworks; Financial Interests, Personal, Invited Speaker: Lilly, Janssen; Financial Interests, Institutional, Research Grant: Amc Medical Research, Armo Biosciences, Basilea, Biokeralty Research Institute, Merck Sharp & Dohme, Oncomed Pharmaceuticals, QED Therapeutics, VCN Biosciences, AbbVie Farmaceútica, Ability Pharmaceuticals, Agios, Amgen, Aslan, AstraZecena, Bayer, BeiGene, Biolinerx, Blueprint Medicines, Boston Biomedical, Bristol Myers Squibb (BMS), Cantargia, Celgene, Eisai, Erytech Pharma, F. Hoffmann-la Roche, FibroGen, Genentech, Hallozyme, Immunomedics, Incyte, Ipsen, Lab. Menarini, Lilly, Loxo Oncology, MedImmune, Merimarck, Novocure, Millenim, Nelum, Novartis, Zymeworks, Pfizer, Pharmacyclics, Roche; Non-Financial Interests, Member: American Society of Clinical Oncology - ASCO, “Sociedad Española de Oncología Médica” – SEOM, Sociedad Europea de Oncología Médica - ESMO. A.J. Munoz Martin: Other, Speaker’s Bureau: Rovi, STADA, Menarini, Amgen, Merck; Other, Research Funding: Rovi, Celgene, Leo Pharma; Other, Other, Patents, royalties, other intellectual property: -; Other, Other, Travel, accomodation, expenses: AstraZeneca, Amgen, Merck, Roche. R. Vidal Tocino: Financial Interests, Personal, Invited Speaker: Amgen, Merck, Servier, BMS, Bayer, MSD; Financial Interests, Personal, Advisory Board: Servier, GSK; Non-Financial Interests, Member: ACLO- Asociación Castellano-Leonesa de Oncología, SEOM-Sociedad Española de Oncología Médica; Other, Other, Travel and accommodation: Servier, Roche, MSD. J. Gallego Plazas: Financial Interests, Personal, Advisory Board: AAA, Amgen, Bayer, BMS, Eisai, Ipsen, Lilly, Merck, MSD, Pierre-Fabre, Roche, Servier; Financial Interests, Personal, Invited Speaker: AAA, Amgen, Bayer, BMS, Ipsen, Lilly, Merck, MSD, Novartis, Servier; Financial Interests, Personal, Other, Educational: Amgen, Ipsen, Merck, Novartis, Pierre-Fabre, Roche; Financial Interests, Institutional, Funding: Astellas, AstraZeneca, BMS, Daiichi Sankyo, Lilly, Servier; Non-Financial Interests, Member of Board of Directors: Spanish Society Medical Oncology, Spanish Group Of Neuroendocrine an Endocrine Tumours; Non-Financial Interests, Project Lead: Agamenon-SEOM Registry of Esophagohastric Cancer. I. Ghanem: Other, Other, Honoraria: Servier, Merck; Other, Other, Consulting or Advisory role: Servier, Merck, Pierre Fabre; Other, Speaker’s Bureau: Servier, Merck, Pierre Fabre, Roche; Other, Other, Travel, accomodation, expenses: Servier; Financial Interests, Other, Travel, accomodation, expenses: Merck, Amgen, Bayer, Pierre Fabre. R. Vera: Financial Interests, Personal, Advisory Board: Roche, Amgen, Sanofi; Financial Interests, Personal, Invited Speaker: Merck, Bayer, EISAI, Servier; Financial Interests, Personal, Other, Program Coordinator: Lilly. M. Lobo de Mena: Financial Interests, Personal, Invited Speaker: Leo Pharma, Servier. M. Melian: Other, Other, Honoraria: Servier, Amgen, Merck, Bayer; Other, Other, Consulting or Advisory role: Servier, Merck; Other, Other, Consulting or advisory role: Amgen; Other, Other, Travel, accomodation, expenses: Servier, Amgen, Merck, Bayer. A. Fernandez Montes: Financial Interests, Personal, Invited Speaker: Lilly, Pierre Fabre, Amgen, Servier, Eisai, AstraZeneca, MSD. All other authors have declared no conflicts of interest.