Abstract 362P
Background
Pancreatic ductal adenocarcinoma (PDAC) presents challenges in timely diagnosis, staging, and initiation of treatment, often with complex symptomatology and psychosocial needs. Established in 2014, the Wallace McCain Centre for Pancreatic Cancer (WMCPC), an interprofessional clinic, notably enhances oncological operations. This includes reducing time to first assessment, biopsy, and access to allied health professionals. Our efforts have significantly improved patient outcomes, including median overall survival (mOS) and well-being compared to standard care. This study updates the impact of our operations on patient care for this vulnerable population.
Methods
This retrospective study included PDAC pts at WMCPC from 2022-2023 versus 2015-2016. Therapeutic approaches (surgery, chemotherapy, radiation) were consistent. Comparisons of cohorts included referral patterns, diagnosis timelines, treatment initiation, allied health consultations, and mOS. Continuous variable: Mann-Whitney U test; Survival analysis: Survival analysis: Cox proportional hazards model.
Results
A total of 1,356 patients were included, with 663 patients between 2022-2023 compared to 693 patients between 2015-2016. Time from referral to initial assessment (7 vs. 7 days, p=0.64), biopsy (7 vs. 6 days (p=0.25), ERCP (5 vs. 6 days, p=0.87), and initiation of neoadjuvant (21.5 vs. 21 days, p=0.55) and palliative therapies (27 vs. 25 days, p=0.30) showed no significant change. However, significant improvements were observed in time to staging imaging (MRI: 11 vs. 14 days (p=0.02); CT: 1 vs. 7 days (p<0.01), adjuvant therapy (71 vs. 88 days; 8 vs. 6 cycles completed, p=0.01), and access to social work (5 vs. 14 days, p=0.02) and dietitian (7 vs. 13 days, p=0.06) services. These improvements correlated with enhanced overall survival rates (HR 0.45, 95%CI 0.38-0.56, p=0.01). We are currently conducting a comparative analysis with provincial government data from 2022-2023 to further enrich our findings.
Conclusions
The implementation of an interprofessional clinic for PDAC patients consistently enhances timely treatment delivery, access to psychosocial and supportive care, and overall survival. These results underscore the model's merit for wider adoption in PDAC care.
Legal entity responsible for the study
Princess Margaret Cancer Centre.
Funding
The Princess Margaret Cancer Foundation Wallace McCain Centre for Pancreatic Cancer.
Disclosure
J.J. Knox: Financial Interests, Personal and Institutional, Other, Paid Consultant and Research/Grants to Institution: AstraZeneca, Roche, Ibsen; Financial Interests, Personal and Institutional, Other, Paid Consultant and Research/Grants to Institution Consultant, Research/Grants to Institution: Merck; Financial Interests, Personal, Other, Paid Consultant: Eisai, Pfizer, Incyte. All other authors have declared no conflicts of interest.