Real-world prognostic factors for survival among treated patients with metastatic pancreatic ductal adenocarcinoma Journal Article


Authors: Yu, K. H.; Ozer, M.; Cockrum, P.; Surinach, A.; Wang, S.; Chu, B. C.
Article Title: Real-world prognostic factors for survival among treated patients with metastatic pancreatic ductal adenocarcinoma
Abstract: Background: Many real-world studies of patients with metastatic pancreatic ductal adenocarcinoma (mPDAC) are restricted to single centers, limiting the generalizability of their insights. This study aimed to identify important population-based predictors for survival in patients diagnosed with mPDAC in a broader setting. Methods: Data between 1 January 2017 and 31 December 2019 were extracted from the Flatiron Health EHR database. Treatment-specific predictive models were generated for patients treated with first-line gemcitabine+nab­paclitaxel (GNP), FOLFIRINOX, gemcitabine monotherapy (gem-mono), and second-line liposomal irinotecan-based regimens. The holdout method was used for cross-validation. Age at diagnosis, sex, BMI, smoking status, and ECOG performance score were included in all models with additional demographic, clinical characteristics, and hematological function assessed for inclusion. Results: Of the 3625 patients, 43% received GNP, 26% received FOLFIRINOX, 7% received gem-mono, and 23% received other regimens; 40% (n = 1448) advanced to the second line. Among all first-line patients, the following were included in the final model: prior surgery, white blood cell (WBC) counts, serum albumin (SA), liver function tests (LFTs), serum bilirubin, serum carbohydrate antigen 19–9, and ascites. Models for patients receiving specific therapies differed from the overall model, GNP (ascites removed), FOLFIRINOX (stage at initial diagnosis added), and gem-mono (LFTs omitted). Alkaline phosphatase (ALP), SA, and WBC counts were important predictors of survival among patients treated with second-line liposomal irinotecan. Across all regimens, the strongest predictors of survival were ECOG score, SA, and ALP. Conclusions: In this real-world study of patients with mPDAC, important population prognostic factors of survival were identified in a large cohort of patients receiving systemic treatment. © 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
Keywords: antineoplastic agents; prognostic factors; pancreatic ductal adenocarcinoma; electronic health records; treatment options; real-world evidence
Journal Title: Cancer Medicine
Volume: 10
Issue: 24
ISSN: 2045-7634
Publisher: Wiley Blackwell  
Date Published: 2021-12-01
Start Page: 8934
End Page: 8943
Language: English
DOI: 10.1002/cam4.4415
PROVIDER: scopus
PMCID: PMC8683530
PUBMED: 34811961
DOI/URL:
Notes: Article -- Export Date: 3 January 2022 -- Source: Scopus
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  1. Kenneth Ho-Ming Yu
    133 Yu