Real-world management and outcome of patients with pancreatic adenocarcinoma. Results of the Spanish RETUD gastrointestinal registry

Background: Patient registries better reflect real-world management and outcomes of pancreatic cancer (PC) compared with clinical trials. Patients and methods: The main objective was to characterize patterns of care and outcomes in patients with exocrine PC included in the Spanish gastrointestinal R...

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Main Authors: T. Macarulla, A. Muñoz, E. Martínez de Castro, A. Castillo, M.T. Cano, F. Castet, R. Vidal, A. Ferrández, I. Ghanem, I. Ales, R. Vera, M. Lobo, J. Adeva, M. Melian, I. Gallego, B. Laquente, A. Fernández Montes, P. Peinado, B. García Paredes, R. Pazo, I. García Escobar, I. Ruiz de Mena, A. Carrato, E. Aranda
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:ESMO Real World Data and Digital Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2949820125000050
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Summary:Background: Patient registries better reflect real-world management and outcomes of pancreatic cancer (PC) compared with clinical trials. Patients and methods: The main objective was to characterize patterns of care and outcomes in patients with exocrine PC included in the Spanish gastrointestinal RETUD registry. All analyses are descriptive in nature; therefore, P values are not reported. Results: A total of 1438 patients with a median age of 68.7 years (range: 34-94 years) were included between 1 January 2019 and 31 December 2022. 79.7% of patients had an Eastern Cooperative Oncology Group performance status of 0-1. 54.9% of resectable patients received adjuvant chemotherapy after upfront surgery, with a median overall survival (mOS) of 33.3 months (range: 26.1 months-not reached) for those treated with Folfirinox. 79.5% of metastatic patients received first-line chemotherapy, primarily gemcitabine and nab-paclitaxel (62.6%), with a mOS of 8.7 months (range: 7.1-9.6 months). Overall, 1- and 3-year net survival rates were 46% and 9%, respectively, with a clear increase for resectable/borderline stages. KRAS, microsatellite instability (MSI), and germline BRCA1/2 were determined in 16.4% (81.8% mutated), 21.2% (1.6% MSI-high), and 9.2% (12.8% mutated) of patients, respectively. Conclusions: Our study provides a real-world perspective on PC patients in Spain, revealing very poor survival similar to those reported in population-based and epidemiological studies. Notably, resectable PC patients receiving adjuvant chemotherapy had lower survival compared with those in clinical trials, a trend not observed in more advanced stages. Adherence to international guidelines varied, and clinical trial participation was low. Additionally, access to molecular testing was limited, remaining a significant challenge.
ISSN:2949-8201