Abstract 355P
Background
Pancreatic ductal adenocarcinoma (PDAC) is associated with poor outcomes due to late presentation. Globally, 5 year-survival (5YS) is <10%, with metastatic 5YS being 3%. The 5YS in Australia is slightly better at approximately 12.6% includes early stage disease as well as locally advanced and metastatic. A recent Lancet Oncology registry based study identified Western Australia as having the global best survival for cancers of pancreas, stomach, ovary and colon. We evaluated factors contributing to survival and wish to report updated survival data.
Methods
We conducted a prospective cohort study with all patients treated for PDAC at our institution between April 2008 and February 2023, and followed up to March 2024. All patients had an ECOG performance status of 2 or less prior to starting treatment. Overall survival (OS) was calculated via Kaplan-Meier method.
Results
There were 330 patients identified in our cohort. Of these, at diagnosis 170 patients (51.5%) were metastatic and 160 patients (48.5%) locally advanced disease. The median age of patients was 66 years (range, 25-87 years). The treatment modalities varied between patients. Overall 160 patients were treated with chemotherapy alone, 79 patients had chemo-radiotherapy, 1 patient received Cyberknife stereotactic body RT alone, 40 patients had chemotherapy and surgery and 50 patients had tri-modality treatment including chemotherapy, surgery, and radiotherapy. Across the groups who received chemotherapy, 140 patients received mFOLFIRINOX as second-line and 60 patients received gemcitabine with nab-paclitaxel as third-line retreatment. The OS of the combined groups was 22 months [95% CI, 19.5-24.5]. In the metastatic group OS was 16 months (95% CI, 14-18) and in the non-metastatic group OS was 31 months (95% CI, 27-35). 5YS overall for our cohort was 12.7%, with metastatic 5YS was 3.5% and non-metastatic was 18.75% respectively.
Conclusions
This prospective analysis shows a significant prolonged OS for patients with locally advanced and metastatic disease. Factors identified as hypothesis of improved outcomes as demonstrated with the use of second-line mFOLFIRINOX, as well as third-line retreatment with gemcitabine and nab-paclitaxel.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
A. Dean: Financial Interests, Invited Speaker, Speakers' Bureau: Juniper Biologics; Financial Interests, Other, travel, accommodation, expenses: Servier. All other authors have declared no conflicts of interest.