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• W2891404575 abstract "6561 Background: FOLFIRINOX (FFN), nab-paclitaxel plus gemcitabine (NG), and gemcitabine (gem) are 3 systemic therapies that provide clinically meaningful benefit to patients (pts) with unresectable pancreatic cancer (UPC). However, there are no clinical trials that directly compare the efficacy of all 3 regimens. Our aim was to examine and compare the real world effectiveness of these treatments. Methods: Pts diagnosed with UPC who initiated palliative first line chemotherapy from August 2014 to August 2015 at any 1 of 5 cancer centers in British Columbia were identified from the provincial pharmacy. Clinical, pathological, treatment, and outcome characteristics were compared. Results: A total of 150 pts were included: 53% men, 78% ECOG 0/1, 71% metastatic disease, and 41% alive at time of analysis with a median follow-up of 1 year. Pts who received FFN were younger (p < 0.001), in better performance status (p < 0.001), and had less disease burden at presentation (p = 0.049). Pts treated with FFN or NG experienced significantly longer median overall survival (OS) when compared to those treated with gem (7.8 vs 8.5 vs 3.1 months, respectively, p < 0.001). This observation persisted after adjusting for confounders such as age and ECOG (Table). Likewise, progression-free survival (PFS) was also longer among pts on FFN or NG in comparison to gem (Table). Pts on FFN and gem required dose modification earlier on treatment than NG (14, 21, and 44 days respectively, p = 0.0407). Treatment discontinuation due to toxicities was common and occurred in 36%, 17%, 23% of cases on FFN, NG, and gem, respectively (p = 0.119). Conclusions: Delivery of FFN required early dose modification in the majority of pts. Receipt of modified FFN and NG portends a better prognosis than gem alone. In the absence of a randomized comparison of all 3 regimens, our population-based study reveals that the introduction of modified FFN and NG confers real world effectiveness for UPC pts. Treatment N Median Age HR OS P HR PFS P Gem 32 74 ref ref NG 59 69 0.156 (0.076 – 0.331) <0.001 0.327 (0.180 – 0.595) <0.001 FFN 59 63 0.224 (0.100 – 0.500) <0.001 0.420 (0.219 – 0.803) 0.009" @default.
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• W2891404575 date "2016-05-20" @default.
• W2891404575 modified "2023-10-16" @default.
• W2891404575 title "Comparative effectiveness of FOLFIRINOX or nab-paclitaxel plus gemcitabine in locally advanced or metastatic pancreatic cancer: A population-based analysis." @default.
• W2891404575 doi "https://doi.org/10.1200/jco.2016.34.15_suppl.6561" @default.
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