Clinical characteristics, molecular landscape and survival outcomes of metastatic pancreatic cancer from western India.
Year: 2025
Type: conference-abstract
Abstract: e16401 Background: Pancreatic cancer is an aggressive malignancy often diagnosed at an advanced, metastatic stage, leading to poor prognosis. Methods: This retrospective study included patients diagnosed with metastatic pancreatic cancer between March 2018 and September 2024. Survival analysis was performed using Kaplan-Meier method. Results: A total of 353 patients were included in the study, with a median age of 65 years (IQR 56–71) and F:M ratio of 1:1.3. Distribution of patients according to ECOG-PS (Eastern Cooperative Oncology Group-Perfomance Status) was : 0-1 in 270 patients (76.5%) and > = 2 in 83 patients (23.5%). A total of 302 patients (85.6%) had de novo metastatic disease, while 51 patients (14.4%) had metachronous metastases. Predominant sites of metastases were: liver (n = 250, 70.8%), distant lymph nodes (n = 142, 40.2%), lung/pleura (n = 70,19.8%), and peritoneum (n = 30 (8.5%). Pancreatic head was the most common site (44.4%), followed by body and tail (27.8% each). The median follow-up was 17.3 months (95% CI: 14.3–20.3) and 235 patients received systemic therapy, 65 were offered best supportive care alone while 53 patients were lost to follow-up. Most common first-line treatment regimens were Gemcitabine-nabpaclitaxel (GN) (n = 93) and FOLFIRINOX (n = 50). Median overall survival (mOS) for the whole cohort was 9.6 months (95% CI: 8.2–10.9) with 2-year OS of 20%. Patients who received GN had mOS of 12.2 months (95% CI: 8.1–16.3), while mOS among those who received FOLFIRINOX was 10.9 months (95% CI: 6.7–15.1) and it was 11.4 months (95% CI: 8.0–14.9) for those who received other regimens (p = 0.796). First-line PFS of the cohort was 8.4 months (95% CI: 6.8–9.9). Univariate and multivariate analysis showed that ECOG-PS > = 2, liver and lung metastases were poor prognostic factors for OS, while age < = 50, tumor location, first-line chemotherapy regimen were not found to be significant factors. Mutational analysis using NGS was performed in 111 patients, with most common alterations being KRAS (40.5%) and TP53 (36.9%). Additional alterations of interest included HER2 amplification (3.6%), BRCA1/2 (2.7%), BRAF (0.9%) and RET (0.9%). The mOS was 18.7 months for KRAS -mutant/ TP53 -wild-type, 14.5 months for KRAS -wild-type/ TP53 -mutant, 14.6 months for KRAS -mutant/ TP53 -mutant, and 18.3 months for KRAS -wild-type/ TP53 -wild-type tumors ( p = 0.477). Conclusions: This study demonstrates the real-world outcomes of metastatic pancreatic cancer highlighting that poor performance status, advanced stage at presentation and patient attrition remain key challenges and newer therapies are needed to improve survival outcomes.
Source: Journal of Clinical Oncology
Authors: Kunal Naishadh Jobanputra, Kshitij Joshi, Udip Maheshwari, Ashish Joshi, Vashishth Maniar, Pritam Kalaskar, Smit Sheth, Pradip Kendre, Krushna Chaudhari, Taha Sethjiwala, Akshay Shivchhand, Prakash Devde, Chandrashekhar Pethe, Sonal Dhande, Disha Morzaria, Shrenika Bhosale, Mangesh ASHOK Mekha, Makarand Randive, Ritu Dave
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4410815446