Abstract
IntroductionAs first reported at the June 2010 ASCO meeting, FOLFIRINOX is a chemotherapy regimen with proven efficacy for metastatic pancreatic cancer; however, its toxicity profile may limit its use to a subset of patients. A proprietary EHR data warehouse of approximately 650,000 cancer patients from 70 institutions comprising 330 oncology clinics in the US provides a unique resource to evaluate actual clinical practice. We described demographic and clinical characteristics of metastatic pancreatic cancer patients who were prescribed FOLFIRINOX at any time after diagnosis and as first line of treatment, and those patients who were not, using real world clinical data from a proprietary EHR warehouse. MethodsPatients and treatment characteristics were collected for incident cases of metastatic pancreatic cancer diagnosed between July 1 2010 and November 30 2011. Multiple logistic regression was used to identify factors predictive of FOLFIRINOX administration during the study period. Results2945 active pancreatic cancer patients were identified. Of those with staging information, 838 (63.0%) were metastatic at the time of diagnosis, with 514 receiving any chemotherapeutic treatment. Of the 514, 53 (10.3%) received FOLFIRINOX at any time after diagnosis, including 38 (7.4%) who received FOLFIRINOX as first line of treatment. Mean age at diagnosis was 58.4 in the FOLFIRINOX group compared to 66.9 years in the no FOLFIRINOX group (p<0.0001). Major factors significantly associated with FOLFIRINOX treatment of metastatic patients in multivariate analysis were: age<65 years (OR= 4.7, 95% CI 2.4-9.1), male sex (OR=2.1, 1.1-3.9), and first diagnosis occurring after May 2011 (OR=1.9, 1.0-3.5). Moreover, factors associated with FOLFIRINOX as first line of treatment were age <65 (OR=6.9, 2.9-16.2) and first diagnosis occurring after May 2011 (OR=3.2, 1.6-6.5). Tumor location was not a statistically significant predictor of FOLFIRINOX administration. ConclusionUtilizing a US-based, proprietary EHR warehouse, this analysis reports real world practice data on the use of FOLFIRINOX in metastatic pancreatic cancer patients. Compared to patients receiving other treatment options, those receiving FOLFIRINOX were younger, more likely to be male, and to have been diagnosed after the May 2011 journal publication of the results first reported at the 2010 ASCO meeting.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have