Real-world management and outcome of patients with pancreatic adenocarcinoma. Results of the Spanish RETUD gastrointestinal registry

Background: Patient registries better reflect real-world management and outcomes of pancreatic cancer (PC) compared with clinical trials. Patients and methods: The main objective was to characterize patterns of care and outcomes in patients with exocrine PC included in the Spanish gastrointestinal R...

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Autores: Macarulla, Teresa, Laquente, Berta, Aranda, Enrique
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/226918
Acceso en línea:https://hdl.handle.net/2445/226918
Access Level:acceso abierto
Palabra clave:Càncer de pàncrees
Càncer gastrointestinal
Càncer d'estómac
Pancreas cancer
Gastrointestinal cancer
Stomach cancer
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spelling Real-world management and outcome of patients with pancreatic adenocarcinoma. Results of the Spanish RETUD gastrointestinal registryMacarulla, Teresa Laquente, BertaAranda, Enrique Càncer de pàncreesCàncer gastrointestinalCàncer d'estómacPancreas cancerGastrointestinal cancerStomach cancerBackground: Patient registries better reflect real-world management and outcomes of pancreatic cancer (PC) compared with clinical trials. Patients and methods: The main objective was to characterize patterns of care and outcomes in patients with exocrine PC included in the Spanish gastrointestinal RETUD registry. All analyses are descriptive in nature; therefore, P values are not reported. Results: A total of 1438 patients with a median age of 68.7 years (range: 34-94 years) were included between 1 January 2019 and 31 December 2022. 79.7% of patients had an Eastern Cooperative Oncology Group performance status of 0-1. 54.9% of resectable patients received adjuvant chemotherapy after upfront surgery, with a median overall survival (mOS) of 33.3 months (range: 26.1 months-not reached) for those treated with Folfirinox. 79.5% of metastatic patients received first-line chemotherapy, primarily gemcitabine and nab-paclitaxel (62.6%), with a mOS of 8.7 months (range: 7.1-9.6 months). Overall, 1-and 3-year net survival rates were 46% and 9%, respectively, with a clear increase for resectable/borderline stages. KRAS, microsatellite instability (MSI), and germline BRCA1/2 were determined in 16.4% (81.8% mutated), 21.2% (1.6% MSI-high), and 9.2% (12.8% mutated) of patients, respectively. Conclusions: Our study provides a real-world perspective on PC patients in Spain, revealing very poor survival similar to those reported in population-based and epidemiological studies. Notably, resectable PC patients receiving adjuvant chemotherapy had lower survival compared with those in clinical trials, a trend not observed in more advanced stages. Adherence to international guidelines varied, and clinical trial participation was low. Additionally, access to molecular testing was limited, remaining a significant challenge.Elsevier BV2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://hdl.handle.net/2445/226918Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Dipòsit Digital de la UBinstname:Universidad de BarcelonaInglésReproducció del document publicat a: https://doi.org/10.1016/j.esmorw.2025.100116ESMO Real World Data and Digital Oncology, 2025, vol. 7, 100116https://doi.org/10.1016/j.esmorw.2025.100116cc-by-nc-nd (c) Macarulla, Teresa et al., 2025http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:diposit.ub.edu:2445/2269182026-05-27T06:46:51Z
dc.title.none.fl_str_mv Real-world management and outcome of patients with pancreatic adenocarcinoma. Results of the Spanish RETUD gastrointestinal registry
title Real-world management and outcome of patients with pancreatic adenocarcinoma. Results of the Spanish RETUD gastrointestinal registry
spellingShingle Real-world management and outcome of patients with pancreatic adenocarcinoma. Results of the Spanish RETUD gastrointestinal registry
Macarulla, Teresa
Càncer de pàncrees
Càncer gastrointestinal
Càncer d'estómac
Pancreas cancer
Gastrointestinal cancer
Stomach cancer
title_short Real-world management and outcome of patients with pancreatic adenocarcinoma. Results of the Spanish RETUD gastrointestinal registry
title_full Real-world management and outcome of patients with pancreatic adenocarcinoma. Results of the Spanish RETUD gastrointestinal registry
title_fullStr Real-world management and outcome of patients with pancreatic adenocarcinoma. Results of the Spanish RETUD gastrointestinal registry
title_full_unstemmed Real-world management and outcome of patients with pancreatic adenocarcinoma. Results of the Spanish RETUD gastrointestinal registry
title_sort Real-world management and outcome of patients with pancreatic adenocarcinoma. Results of the Spanish RETUD gastrointestinal registry
dc.creator.none.fl_str_mv Macarulla, Teresa
Laquente, Berta
Aranda, Enrique
author Macarulla, Teresa
author_facet Macarulla, Teresa
Laquente, Berta
Aranda, Enrique
author_role author
author2 Laquente, Berta
Aranda, Enrique
author2_role author
author
dc.subject.none.fl_str_mv Càncer de pàncrees
Càncer gastrointestinal
Càncer d'estómac
Pancreas cancer
Gastrointestinal cancer
Stomach cancer
topic Càncer de pàncrees
Càncer gastrointestinal
Càncer d'estómac
Pancreas cancer
Gastrointestinal cancer
Stomach cancer
description Background: Patient registries better reflect real-world management and outcomes of pancreatic cancer (PC) compared with clinical trials. Patients and methods: The main objective was to characterize patterns of care and outcomes in patients with exocrine PC included in the Spanish gastrointestinal RETUD registry. All analyses are descriptive in nature; therefore, P values are not reported. Results: A total of 1438 patients with a median age of 68.7 years (range: 34-94 years) were included between 1 January 2019 and 31 December 2022. 79.7% of patients had an Eastern Cooperative Oncology Group performance status of 0-1. 54.9% of resectable patients received adjuvant chemotherapy after upfront surgery, with a median overall survival (mOS) of 33.3 months (range: 26.1 months-not reached) for those treated with Folfirinox. 79.5% of metastatic patients received first-line chemotherapy, primarily gemcitabine and nab-paclitaxel (62.6%), with a mOS of 8.7 months (range: 7.1-9.6 months). Overall, 1-and 3-year net survival rates were 46% and 9%, respectively, with a clear increase for resectable/borderline stages. KRAS, microsatellite instability (MSI), and germline BRCA1/2 were determined in 16.4% (81.8% mutated), 21.2% (1.6% MSI-high), and 9.2% (12.8% mutated) of patients, respectively. Conclusions: Our study provides a real-world perspective on PC patients in Spain, revealing very poor survival similar to those reported in population-based and epidemiological studies. Notably, resectable PC patients receiving adjuvant chemotherapy had lower survival compared with those in clinical trials, a trend not observed in more advanced stages. Adherence to international guidelines varied, and clinical trial participation was low. Additionally, access to molecular testing was limited, remaining a significant challenge.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/226918
url https://hdl.handle.net/2445/226918
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.1016/j.esmorw.2025.100116
ESMO Real World Data and Digital Oncology, 2025, vol. 7, 100116
https://doi.org/10.1016/j.esmorw.2025.100116
dc.rights.none.fl_str_mv cc-by-nc-nd (c) Macarulla, Teresa et al., 2025
http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by-nc-nd (c) Macarulla, Teresa et al., 2025
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Elsevier BV
publisher.none.fl_str_mv Elsevier BV
dc.source.none.fl_str_mv Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
reponame:Dipòsit Digital de la UB
instname:Universidad de Barcelona
instname_str Universidad de Barcelona
reponame_str Dipòsit Digital de la UB
collection Dipòsit Digital de la UB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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