Treatment outcomes in recurrent versus de novo metastatic pancreatic adenocarcinoma: a real world study
Abstract Background A majority of patients undergoing curative intent surgery for pancreatic ductal adenocarcinoma (PDAC) will unfortunately develop recurrent disease. Treatment outcomes for patients with metastatic disease remain suboptimal. In this study, we evaluated clinical outcomes of patients...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-10-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-022-10130-4 |
| _version_ | 1828141848328142848 |
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| author | Laura Miotke Christopher Nevala-Plagemann Jian Ying Vaia Florou Benjamin Haaland Ignacio Garrido-Laguna |
| author_facet | Laura Miotke Christopher Nevala-Plagemann Jian Ying Vaia Florou Benjamin Haaland Ignacio Garrido-Laguna |
| author_sort | Laura Miotke |
| collection | DOAJ |
| description | Abstract Background A majority of patients undergoing curative intent surgery for pancreatic ductal adenocarcinoma (PDAC) will unfortunately develop recurrent disease. Treatment outcomes for patients with metastatic disease remain suboptimal. In this study, we evaluated clinical outcomes of patients with recurrent PDAC who received systemic therapy and compared outcomes to patients with de novo metastatic PDAC undergoing systemic therapy. Methods Patients diagnosed with metastatic PDAC between 2014 and 2019 were included using a real-world database. Patients were characterized as either de novo or recurrent based on the date of metastatic diagnosis and history of surgical resection. Overall survival (OS) was summarized within groups via Kaplan–Meier survival estimates and compared using Cox proportional hazards models. Results We included 5170 patients with metastatic PDAC, of which 1101 (21.3%) were classified as having recurrent disease. Median OS for the recurrent group was significantly greater at 10.8 m (95% CI 9.9–11.7) than in the de novo group at 7.3 m (95% CI 7.0–7.7, p < 0.001). We did not observe a significant difference in OS based on when patients recurred after surgery: 10.0 m (95% CI 8.7–11) within six months of surgery versus 11.6 m (95% CI 10–12, p = 0.256) greater than six months from surgery. Conclusions These data support the inclusion of patients with recurrent PDAC in clinical trials for advanced disease, including those who develop recurrent disease within six months of surgery. Due to observed differences in survival, randomization should be stratified by disease presentation (recurrent vs de novo). |
| first_indexed | 2024-04-11T19:31:43Z |
| format | Article |
| id | doaj.art-455224d7cb18463dbcdd2889a187d428 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-11T19:31:43Z |
| publishDate | 2022-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-455224d7cb18463dbcdd2889a187d4282022-12-22T04:06:58ZengBMCBMC Cancer1471-24072022-10-012211810.1186/s12885-022-10130-4Treatment outcomes in recurrent versus de novo metastatic pancreatic adenocarcinoma: a real world studyLaura Miotke0Christopher Nevala-Plagemann1Jian Ying2Vaia Florou3Benjamin Haaland4Ignacio Garrido-Laguna5Division of Medical Oncology, Huntsman Cancer InstituteDivision of Medical Oncology, Huntsman Cancer InstituteDepartment of Population Health SciencesDivision of Medical Oncology, Huntsman Cancer InstituteDepartment of Population Health SciencesDivision of Medical Oncology, Huntsman Cancer InstituteAbstract Background A majority of patients undergoing curative intent surgery for pancreatic ductal adenocarcinoma (PDAC) will unfortunately develop recurrent disease. Treatment outcomes for patients with metastatic disease remain suboptimal. In this study, we evaluated clinical outcomes of patients with recurrent PDAC who received systemic therapy and compared outcomes to patients with de novo metastatic PDAC undergoing systemic therapy. Methods Patients diagnosed with metastatic PDAC between 2014 and 2019 were included using a real-world database. Patients were characterized as either de novo or recurrent based on the date of metastatic diagnosis and history of surgical resection. Overall survival (OS) was summarized within groups via Kaplan–Meier survival estimates and compared using Cox proportional hazards models. Results We included 5170 patients with metastatic PDAC, of which 1101 (21.3%) were classified as having recurrent disease. Median OS for the recurrent group was significantly greater at 10.8 m (95% CI 9.9–11.7) than in the de novo group at 7.3 m (95% CI 7.0–7.7, p < 0.001). We did not observe a significant difference in OS based on when patients recurred after surgery: 10.0 m (95% CI 8.7–11) within six months of surgery versus 11.6 m (95% CI 10–12, p = 0.256) greater than six months from surgery. Conclusions These data support the inclusion of patients with recurrent PDAC in clinical trials for advanced disease, including those who develop recurrent disease within six months of surgery. Due to observed differences in survival, randomization should be stratified by disease presentation (recurrent vs de novo).https://doi.org/10.1186/s12885-022-10130-4Real-world outcomesOverall survivalPancreatic ductal adenocarcinomaRecurrentDe Novo |
| spellingShingle | Laura Miotke Christopher Nevala-Plagemann Jian Ying Vaia Florou Benjamin Haaland Ignacio Garrido-Laguna Treatment outcomes in recurrent versus de novo metastatic pancreatic adenocarcinoma: a real world study BMC Cancer Real-world outcomes Overall survival Pancreatic ductal adenocarcinoma Recurrent De Novo |
| title | Treatment outcomes in recurrent versus de novo metastatic pancreatic adenocarcinoma: a real world study |
| title_full | Treatment outcomes in recurrent versus de novo metastatic pancreatic adenocarcinoma: a real world study |
| title_fullStr | Treatment outcomes in recurrent versus de novo metastatic pancreatic adenocarcinoma: a real world study |
| title_full_unstemmed | Treatment outcomes in recurrent versus de novo metastatic pancreatic adenocarcinoma: a real world study |
| title_short | Treatment outcomes in recurrent versus de novo metastatic pancreatic adenocarcinoma: a real world study |
| title_sort | treatment outcomes in recurrent versus de novo metastatic pancreatic adenocarcinoma a real world study |
| topic | Real-world outcomes Overall survival Pancreatic ductal adenocarcinoma Recurrent De Novo |
| url | https://doi.org/10.1186/s12885-022-10130-4 |
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