PCN27 Real-World Characteristics and Outcomes of Patients with Metastatic Ductal Adenocarcinoma (MPDAC) Treated with Liposomal Irinotecan-Based Regimens By Race

Abstract

Racial disparities persist in outcomes for patients with pancreatic cancer in the United States, with Black or African American patients having higher age-adjusted incidence and mortality than White patients. Similarly, results from the pivotal phase 3 study, NAPOLI-1, and recent literature suggest that participants of East Asian ethnic origin experience better outcomes than other ethnic groups with liposomal irinotecan+5-fluorouracil/leucovorin following gemcitabine. This study seeks to describe clinical characteristics and treatment outcomes based on race. This retrospective observational study utilized the Flatiron Health EHR-derived de-identified database from over 280 cancer clinics in the US. Data were analyzed for adult patients with mPDAC treated with liposomal irinotecan-based regimens between January 2015 and February 2020. Patients were stratified based on their self-reported race. Median overall survival (OS) from treatment initiation was derived using Kaplan-Meier analysis. Of the included 608 patients (median age 68 years (y), IQR: 61-74) with mPDAC and treated with a liposomal irinotecan-based regimen, 448 patients (73.7%) were White, 48 patients (7.9%) were Black or African American, 13 (2.1%) were Asian, and 99 (16.3%) were of other race or the data were missing. White patients had a median age at metastatic diagnosis of 69y (IQR: 61–74), Black patients, 64y (60-71), and Asian patients 65y (63-72). ECOG scores of 0-1 were reported for 61.6% of White patients, 58.3% of Black patients, and 61.5% of Asian patients. Overall, median OS was 4.7 months (95% CI: 4.2–5.4). Median OS was 4.6 months 4.1–5.6) among White patients, 3.8 months (3.1–5.6) among Black patients, and 12 months (3.4–NR) among Asian patients. This analysis found racial disparities may persist in survival outcomes among patients with mPDAC treated with liposomal irinotecan-based regimens. Further studies are needed to characterize and understand the biological and socio-economic factors contributing to these disparate outcomes.