Locally advanced and metastatic pancreatic cancer: An assessment of the provision of chemotherapy at a tertiary referral hospital — ASN Events
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Locally advanced and metastatic pancreatic cancer: An assessment of the provision of chemotherapy at a tertiary referral hospital (#372)

Hayden Christie 1 , Matthew Burge 1 , Melissa Eastgate 1 , David Wyld 1
  1. Royal Brisbane and Women's Hospital, Herston, QLD, Australia

Background

Recently, chemotherapy options have expanded for patients with advanced pancreatic cancer. FOLFIRINOX has recently become the standard first line regimen at our institution. We therefore analysed chemotherapy delivery, toxicity, patient characteristics and outcome prior to this time as a reference for future comparison.

Methods

A chart review was conducted on 34 consecutive patients with inoperable advanced pancreatic adenocarcinoma treated with chemotherapy at the Royal Brisbane and Women’s Hospital from January 2011 to December 2013. Data was collected on patient characteristics, chemotherapy duration, clinical trial enrolment, subsequent treatment lines, response (CA19.9, CT) and survival. Dose reductions and hospital admissions were measured as indicators of treatment toxicity. 

Results

Patients received a median 14 weeks of 1st line treatment with 6 (18%) on a clinical trial. 30 (88%) received gemcitabine, 3 (9%) FOLFOX and 1 (3%) FOLFIRINOX. 10 (29%) received second line treatment, 3 (9%) 3rd line treatment. 21 (62%) required admission during chemotherapy for 40 admissions in total with 9 (26%) for treatment toxicity. 11 (32%) required dose reduction during first line treatment. 23 (68%) had tumour in the head of the pancreas with 16 requiring stenting (13 prior, 3 during chemotherapy).  Baseline characteristics were:  50% were ≥70 years old; 44% ECOG 0-1, 3% ECOG 2, 53% not recorded; median bilirubin 17micromol/L, albumin 35g/L, and LDH 265U/L; 41% had a recorded reduction in CA19.9 and 26% a CT response. Median survival was 7.5 months (evaluable for 20 patients). 

Conclusion

We now have an accurate baseline of our advanced pancreatic cancer patients and their characteristics which we can compare to going forward.  Given we are a tertiary referral centre we were surprised at the small number of patients seen over a 3 year period, further research could look at reasons for this.  Our department has a strong track record of clinical trial work and this data will be used to help guide our involvement in and development of future clinical trials.

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