Real-World Dosing Patterns and Outcomes of Patients with Metastatic Pancreatic Cancer Treated with a Liposomal Irinotecan Regimen in the United States

Afsaneh Barzi, Rebecca Miksad, Andy Surinach, Frank A. Corvino, Siqi Wang, Aracelis Z. Torres, Khalid Mamlouk, Sonia Pulgar, Adriana Valderrama, Tanios Bekaii-Saab, Daniel Ahn

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)193-200
Number of pages8
JournalPancreas
Volume49
Issue number2
DOIs
StatePublished - Feb 1 2020

Keywords

  • gemcitabine
  • liposomal irinotecan
  • metastatic pancreatic cancer
  • nab-paclitaxel
  • serum albumin
  • topoisomerase inhibitor

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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