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Open AccessArticle

Survival Benefits of Chemotherapy for Patients with Advanced Pancreatic Cancer in A Clinical Real-World Cohort

1
Department of Clinical Science, Intervention and Technology, Karolinska Institute, 171 77 Stockholm, Sweden
2
Upper Gastrointestinal Unit, Cancer Division, Karolinska University Hospital, 171 76 Stockholm, Sweden
3
Department of Medical Epidemiology and Biostatistics, Karolinska Institute, 171 77 Stockholm, Sweden
4
Department of Oncology-Pathology, Karolinska Institute, 171 76 Stockholm, Sweden
*
Author to whom correspondence should be addressed.
Cancers 2019, 11(9), 1326; https://doi.org/10.3390/cancers11091326
Received: 21 July 2019 / Revised: 1 September 2019 / Accepted: 3 September 2019 / Published: 7 September 2019
Clinical outcomes of chemotherapy for patients with advanced pancreatic adenocarcinoma in a real-world setting might differ from outcomes in randomized clinical trials (RCTs). Here we show in a single-institution cohort of 595 patients that median overall survival (OS) of patients who received gemcitabine alone (n = 185; 6.6 months (95% CI; 5.5–7.7)) was the same as in pivotal RCTs. Gemcitabine/capecitabine (n = 60; 10.6 months (95% CI; 7.8–13.3)) and gemcitabine/nab-paclitaxel (n = 66; 9.8 months (95% CI; 7.9–11.8)) resulted in a longer median OS and fluorouracil/oxaliplatin/irinotecan (n = 31, 9.9 months (95% CI; 8.1–11.7)) resulted in a shorter median OS than previously reported. Fluorouracil/oxaliplatin (n = 35, 5.8 months (95% CI; 4.5–7)) and best supportive care (n = 206, 1.8 months (95% CI; 1.5–2.1)) could not be benchmarked against any RCTs. The degree of protocol adherence explained differences between real-world outcomes and the respective RCTs, while exposure to second-line treatments did not. View Full-Text
Keywords: pancreatic adenocarcinoma; gemcitabine; nab-paclitaxel; capecitabine; FOLFIRINOX; real-world data; first-line treatment; second-line treatment pancreatic adenocarcinoma; gemcitabine; nab-paclitaxel; capecitabine; FOLFIRINOX; real-world data; first-line treatment; second-line treatment
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Kordes, M.; Yu, J.; Malgerud, O.; Gustafsson Liljefors, M.; Löhr, J. .-M. Survival Benefits of Chemotherapy for Patients with Advanced Pancreatic Cancer in A Clinical Real-World Cohort. Cancers 2019, 11, 1326.

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