Observational Study of Clinical Practice in Patients with Pancreatic Adenocarcinoma in Greece

George Papaxoinis; Athanasios Athanasiadis; Joseph Sgouros; Anastastios Visvikis; Maria Drizou; Emmanouil Kontopodis; Anna Koumarianou; Suzana Stojanovska; Gerasimos Aravantinos; Ippokratis Korantzis; Alexandros Ioannou; Ioannis Varthalitis; Dimitrios Doufexis; Michail Nikolaou; Georgios Lypas; Iliada Bompolaki; Athina Christopoulou; Michael Liontos; Nikolaos Tsoukalas; Davide Mauri; Nikolaos Xenidis; Panagiotis Katsaounis; Georgios Oikonomopoulos; Ioannis Boukovinas

doi:10.1155/2020/5304516

Observational Study of Clinical Practice in Patients with Pancreatic Adenocarcinoma in Greece

J Oncol. 2020 Sep 19:2020:5304516. doi: 10.1155/2020/5304516. eCollection 2020.

Authors

George Papaxoinis¹, Athanasios Athanasiadis¹, Joseph Sgouros¹, Anastastios Visvikis¹, Maria Drizou¹, Emmanouil Kontopodis¹, Anna Koumarianou¹, Suzana Stojanovska¹, Gerasimos Aravantinos¹, Ippokratis Korantzis¹, Alexandros Ioannou¹, Ioannis Varthalitis¹, Dimitrios Doufexis¹, Michail Nikolaou¹, Georgios Lypas¹, Iliada Bompolaki¹, Athina Christopoulou¹, Michael Liontos¹, Nikolaos Tsoukalas¹, Davide Mauri¹, Nikolaos Xenidis¹, Panagiotis Katsaounis¹, Georgios Oikonomopoulos¹, Ioannis Boukovinas¹

Affiliation

¹ Hellenic Society of Medical Oncology (HeSMO), Athens, Greece.

Abstract

Background: During the last decade, significant improvement was made in systemic therapy of pancreatic adenocarcinoma (PAC). The impact of this progress in everyday clinical practice has not been fully described yet. The aim of the study was to investigate the pattern followed by Greek Medical Oncologists regarding the treatment of patients with PAC.

Methods: This observational, noninterventional multicenter study recorded clinical data from the files of 200 active patients (alive and under treatment or follow-up) for a two-year period (November 2015 until November 2017) from 20 oncology centers around Greece.

Results: In total, 51 (25.5%) patients underwent radical surgical resection of PAC, and 40 (78.4%) of them received adjuvant and 1 (2.0%) neoadjuvant chemotherapy. The median time to recurrence was 7.9 months, and median overall survival (OS), 20.2 months. First-line chemotherapy was administered to 193 (96.5%) patients. The majority of patients were treated with the combination of nab-paclitaxel-gemcitabine (NPG), 5-fluorouracil, leucovorin, irinotecan, oxaliplatin (FOLFIRINOX), or gemcitabine monotherapy. Of them, 39.5% responded to the treatment. Median OS and PFS were 14.1 months and 7.0 months, respectively. Second-line treatment was administered to 112 patients. The majority received NPG, FOLFIRINOX/capecitabine, oxaliplatin, irinotecan (CAPOXIRI), or 5-fluorouracil, leucovorin, oxaliplatin (FOLFOX)/capecitabine, oxaliplatin (CAPOX). Median OS with second-line treatment was 8.6 months, and median PFS, 5.5 months. The most common chemotherapy sequences were NPG as first-line followed by FOLFIRINOX/CAPOXIRI as second-line, NPG followed by FOLFOX/CAPOX, NPG followed by other regimens, and FOLFIRINOX/CAPOXIRI followed by NPG.

Conclusion: This study described the significant improvement in prognosis of PAC patients receiving palliative chemotherapy and the relatively high rate of receipt of second-line chemotherapy, according to real-world data. However, due to the nonrandomized nature of the study, any comparison between different chemotherapy regimens should be regarded with caution.