Objective:

To assess treatment patterns, characteristics associated with first-line regimen selection, and real-world survival and treatment outcomes in US patients with metastatic pancreatic adenocarcinoma (mPAC).

Approach:

• Study Design: Retrospective analysis of US adults newly diagnosed with mPAC from the Flatiron Health Research Database.
• Patient Selection: Included patients who initiated systemic therapy within 180 days of metastatic diagnosis.
• Data Analysis: Evaluated associations between baseline characteristics and 1L regimen selection using multinomial logistic regression; assessed overall survival (OS) and time-to-treatment discontinuation (TTD) using standard survival methods.

Key Findings:

• Among 9,439 patients with mPAC, 6,279 initiated 1L systemic therapy.
• Most common 1L regimens were gemcitabine plus nab-paclitaxel (41.5%) and FOLFIRINOX (36.3%).
• Median OS was longer for FOLFIRINOX (10.7 months) compared to Gem-Nab (7.6 months; adjusted hazard ratio 0.47).
• 33.5% of patients did not receive systemic therapy within 180 days of metastatic diagnosis.

Interpretation:

Limitations:

• Findings are associative due to substantial differences in patient characteristics between treatment groups.
• Study may not capture all relevant factors influencing treatment decisions and outcomes.

Conclusion: