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Article

Impact of New Chemotherapy Regimens on the Treatment Landscape and Survival of Locally Advanced and Metastatic Pancreatic Cancer Patients

1
Department of Medicine I, Division of Oncology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
2
Department of Surgery, Division of General Surgery, Pancreatic Cancer Unit, Comprehensive Cancer Center Vienna, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(3), 648; https://doi.org/10.3390/jcm9030648
Received: 19 February 2020 / Accepted: 26 February 2020 / Published: 28 February 2020
(This article belongs to the Section Oncology)
Background: New chemotherapy regimens for the treatment of metastatic pancreatic cancer have changed the therapy paradigm. We aimed to assess their impact on the treatment landscape and clinical outcome at our academic institution. Methods: In this single institutional posthoc registry analysis, we assessed characteristics and survival rates from all patients with locally advanced and metastatic pancreatic cancer who started a systemic treatment between 01/2011 and 12/2017. Survival analyses were performed by Kaplan-Meier and Cox proportional hazards model. Results: A total of 301 patients started a systemic treatment in the observation period. In the first line treatment, we observed a shift from the four different main regimens (gemcitabine/nab-paclitaxel, modified FOLFIRINOX, gemcitabine/oxaliplatin +/− erlotinib or gemcitabine alone) to gemcitabine/nab-paclitaxel and modified FOLFIRINOX that add up to more than 80% of administered first line treatments in each of the time cohorts (2011–2013 vs. 2014–2017). The rate for first line modified FOLFIRINOX treatment was balanced between the two groups (19% and 15%). Median overall survival differed significantly between the two time cohorts (8.89 versus 11.9 months, p = 0.035). Survival rates for different first to second line treatment sequences (modified FOLFIRINOX to gemcitabine/nab-paclitaxel, gemcitabine/nab-paclitaxel to fluoropyrimidines plus nanoliposomal irinotecan, or gemcitabine/nab-paclitaxel to fluoropyrimidines plus oxaliplatin) were not significantly different and median overall survival ranged from 14.27 to 15.64 months. Conclusion: Our study provides real-world evidence for the effectiveness of the new chemotherapy regimens and underscores the importance of the choice of the front-line regimen when considering different sequencing strategies. View Full-Text
Keywords: pancreatic ductal adenocarcinoma; treatment landscape; treatment patterns; treatment sequences; new chemotherapy regimens; nanoliposomal irinotecan; nab-paclitaxel; FOLFIRINOX pancreatic ductal adenocarcinoma; treatment landscape; treatment patterns; treatment sequences; new chemotherapy regimens; nanoliposomal irinotecan; nab-paclitaxel; FOLFIRINOX
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MDPI and ACS Style

Kieler, M.; Unseld, M.; Bianconi, D.; Schindl, M.; Kornek, G.V.; Scheithauer, W.; Prager, G.W. Impact of New Chemotherapy Regimens on the Treatment Landscape and Survival of Locally Advanced and Metastatic Pancreatic Cancer Patients. J. Clin. Med. 2020, 9, 648. https://doi.org/10.3390/jcm9030648

AMA Style

Kieler M, Unseld M, Bianconi D, Schindl M, Kornek GV, Scheithauer W, Prager GW. Impact of New Chemotherapy Regimens on the Treatment Landscape and Survival of Locally Advanced and Metastatic Pancreatic Cancer Patients. Journal of Clinical Medicine. 2020; 9(3):648. https://doi.org/10.3390/jcm9030648

Chicago/Turabian Style

Kieler, Markus; Unseld, Matthias; Bianconi, Daniela; Schindl, Martin; Kornek, Gabriela V.; Scheithauer, Werner; Prager, Gerald W. 2020. "Impact of New Chemotherapy Regimens on the Treatment Landscape and Survival of Locally Advanced and Metastatic Pancreatic Cancer Patients" J. Clin. Med. 9, no. 3: 648. https://doi.org/10.3390/jcm9030648

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