Abstract A137: Chemotherapy utilization and outcomes in patients with metastatic pancreatic adenocarcinoma
Shubham Pant, Pranoti Pradhan, Yuexi Wang, Aliza R. Karpes Matusevich, Ziyu Lan, Brandon Kent, Clay Gustafson, John Graham, Preeti S. BajajAbstract
Background:
Metastatic pancreatic adenocarcinoma (mPDAC) is associated with poor prognosis and limited treatment options. While guidelines recommend chemotherapy (CTx) for patients with good performance status (PS), many patients do not receive CTx or discontinue shortly after initiation. Non-treatment is often attributed to poor PS, comorbidities, or organ dysfunction; however, treatment-related factors including toxicity burden and limited effectiveness of available CTx options may also contribute. This study aimed to understand characteristics and outcomes of patients with de novo mPDAC who do not receive or are intolerant to CTx.
Methods:
This study used ConcertAI Patient360™ electronic health records with linked claims. Adult patients were included if they were diagnosed with de novo mPDAC between 1/2020–3/2025 and had >3 months of follow-up unless censored due to death. Patients were categorized into 3 cohorts: CTx-untreated, CTx-tolerant (initiated and continued CTx for >90 days unless due to progression), and CTx-intolerant (initiated CTx within 90 days of diagnosis but discontinued within 90 days without evidence of progression or re-treatment). Demographics, clinical characteristics, overall survival (OS), and resource utilization were evaluated.
Results:
Of the 2708 patients meeting eligibility criteria, 953 (35%) were CTx-untreated. A total of 1635 initiated treatment within 90 days; 1105 (41%) were classified as CTx-tolerant and 530 (20%) as CTx-intolerant. CTx-untreated patients tended to be older and had worse PS. CTx-intolerant patients were slightly older and had worse PS than CTx-tolerant patients. Median OS was 1.74 months in CTx-untreated, 11.37 months in CTx-tolerant, and 2.63 months in CTx-intolerant patients. CTx-untreated and CTx-intolerant patients had higher resource utilization per patient per month.
Conclusions:
In a large cohort of patients with de novo mPDAC, more than half of patients were untreated or unable to tolerate CTx, possibly related to older age and worse PS. Survival was substantially shorter and resource utilization higher in these groups than among those who received and tolerated CTx. While CTx demonstrates improved outcomes among those who receive and tolerate it, these findings also highlight a significant need for improved treatment options for mPDAC.
Citation Format:
Shubham Pant, Pranoti Pradhan, Yuexi Wang, Aliza R. Karpes Matusevich, Ziyu Lan, Brandon Kent, Clay Gustafson, John Graham, Preeti S. Bajaj. Chemotherapy utilization and outcomes in patients with metastatic pancreatic adenocarcinoma [abstract]. In: Proceedings of the AACR Conference on Pancreatic Cancer: New Frontiers in Biology and Therapeutic Development; 2026 Sep 25-28; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(18_Suppl_2):Abstract nr A137.