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Real-world dosing patterns and outcomes of patients with metastatic pancreatic cancer treated with a liposomal irinotecan regimen in the United States

Published

January 2020

Citation

Barzi, A, Miksad, RA, Surinach, A, Corvino, FA, Wang, S, Torres, AZ, Mamlouk, K, Pulgar, S, Valderrama, A, Bekaii-Saab, T, Ahn, D. . Pancreas. .

https://doi.org/10.1097/MPA.0000000000001479

 

Authors:
Barzi, A, Miksad, RA, Surinach, A, Corvino, FA, Wang, S, Torres, AZ, Mamlouk, K, Pulgar, S, Valderrama, A, Bekaii-Saab, T, Ahn, D

Objectives 

Liposomal irinotecan (nal-IRI) is a topoisomerase inhibitor proven to improve survival in metastatic pancreatic cancer (mPC). This study describes real-world characteristics of patients treated with nal-IRI for mPC.

Methods 

Patients 18 years or older diagnosed with stage IV mPC and treated with nal-IRI were selected retrospectively from a deidentified electronic health record database of more than 2 million US cancer patients. Demographics, clinical and dosing characteristics, and treatment outcomes were collected.

Results 

Of 257 total patients, 145 (57%) received nal-IRI as first- or second-line therapy. Median nal-IRI treatment duration was 51 days, longer when nal-IRI was used as first/second versus as third-line therapy or later (62 vs 44.5 days). Seventy patients (27.2%) experienced dose modification. Median time to treatment discontinuation was 2.3 versus 1.6 months for first-/second- versus third-line therapy or later, respectively. Median overall survival from nal-IRI initiation was 5.6 versus 4.1 months for first-/second- versus third-line therapy or later, respectively. Prior irinotecan treatment, baseline serum albumin less than 40 g/L, and baseline neutrophil-to-lymphocyte ratio greater than 5 were associated with reduced overall survival.

Conclusions 

This is the first large US study of real-world US mPC patients treated with nal-IRI. These results, comparable to the NAPOLI-1 trial, can help inform future studies and the efficacy of nal-IRI in mPC therapy.

 

Sources:
Pancreas

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