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© 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Background

In Ontario, FOLFIRINOX (FFX) and gemcitabine + nab‐paclitaxel (GnP) have been publicly funded for first‐line unresectable locally advanced pancreatic cancer (uLAPC) or metastatic pancreatic cancer (mPC) since April 2015. We examined the real‐world effectiveness and safety of FFX vs GnP for advanced pancreatic cancer, and in uLAPC and mPC.

Methods

Patients receiving first‐line FFX or GnP from April 2015 to March 2017 were identified in the New Drug Funding Program database. Baseline characteristics and outcomes were obtained through the Ontario Cancer Registry and other population‐based databases. Overall survival (OS) was assessed using Kaplan‐Meier and weighted Cox proportional hazard models, weighted by the inverse propensity score adjusting for baseline characteristics. Weighted odds ratio (OR) for hospitalization and emergency department visits (EDV) were estimated from weighted logistic regression models.

Results

For 1130 patients (632 FFX, 498 GnP), crude median OS was 9.6 and 6.1 months for FFX and GnP, respectively. Weighted OS was improved for FFX vs GnP (HR = 0.77, 0.70‐0.85). Less frequent EDV and hospitalization were observed in FFX (EDV: 67.8%; Hospitalization: 49.2%) than GnP (EDV: 77.7%; Hospitalization: 59.3%). More frequent febrile neutropenia‐related hospitalization was observed in FFX (5.8%) than GnP (3.3%). Risk of EDV and hospitalization were significantly lower for FFX vs GnP (EDV: OR = 0.68, P = .0001; Hospitalization: OR = 0.76, P = .002), whereas the risk of febrile neutropenia‐related hospitalization was significantly higher (OR = 2.12, P = .001). Outcomes for uLAPC and mPC were similar.

Conclusion

In the real world, FFX had longer OS, less frequent all‐cause EDV and all‐cause hospitalization, but more febrile neutropenia‐related hospitalization compared to GnP.

Details

Title
Real‐world outcomes of FOLFIRINOX vs gemcitabine and nab‐paclitaxel in advanced pancreatic cancer: A population‐based propensity score‐weighted analysis
Author
Chan, Kelvin K W 1   VIAFID ORCID Logo  ; Guo, Helen 2 ; Cheng, Sierra 3   VIAFID ORCID Logo  ; Beca, Jaclyn M 4 ; Ruby Redmond‐Misner 5 ; Isaranuwatchai, Wanrudee 4 ; Qiao, Lucy 2 ; Earle, Craig 6 ; Berry, Scott R 3 ; Biagi, James J 7 ; Welch, Stephen 8 ; Meyers, Brandon M 9 ; Mittmann, Nicole 2 ; Coburn, Natalie 3 ; Arias, Jessica 2 ; Schwartz, Deborah 2 ; Dai, Wei F 2 ; Gavura, Scott 2 ; McLeod, Robin 2 ; Kennedy, Erin D 10   VIAFID ORCID Logo 

 Cancer Care Ontario, Toronto, ON, Canada; Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; Canadian Centre for Applied Research in Cancer Control, Toronto, ON, Canada 
 Cancer Care Ontario, Toronto, ON, Canada 
 Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada 
 Canadian Centre for Applied Research in Cancer Control, Toronto, ON, Canada; Pharmacoeconomics Research Unit, Cancer Care Ontario, Toronto, ON, Canada 
 Pharmacoeconomics Research Unit, Cancer Care Ontario, Toronto, ON, Canada 
 Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada 
 Cancer Centre of Southeastern Ontario, Kingston, ON, Canada 
 London Regional Cancer Program, London, ON, Canada 
 Hamilton Health Sciences Centre, Hamilton, ON, Canada 
10  Cancer Care Ontario, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada 
Pages
160-169
Section
CLINICAL CANCER RESEARCH
Publication year
2020
Publication date
Jan 2020
Publisher
John Wiley & Sons, Inc.
e-ISSN
20457634
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2333500941
Copyright
© 2020. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.