Guideline Application in Real world: multi-Institutional Based survey of Adjuvant and first-Line pancreatic Ductal adenocarcinoma treatment in Italy. Primary analysis of the GARIBALDI survey

ESMO Open

article

M. Reni¹  E. Giommoni²  F. Bergamo³  M. Milella⁴  L. Cavanna⁵  M.C. Di Marco⁶  M. Spada⁷  S. Cordio⁸  G. Aprile⁹  G.G. Cardellino^1,10  E. Maiello^1,11  I. Bernardini^1,12  M. Ghidini^1,13  S. Bozzarelli^1,14  M. Macchini¹  G. Orsi¹  I. De Simone^1,15  Er. Rulli^1,15  L. Porcu^1,15  V. Torri^1,15  C. Pinto^1,16 

[1] Department of Medical Oncology, Vita e Salute University, IRCCS San Raffaele Scientific Institute;Medical Oncology, Azienda Ospedaliero-Universitaria Careggi;Unit of Medical Oncology 1, Department of Clinical and Experimental Oncology, Istituto Oncologico Veneto;Oncology Verona, Policlinico Universitario G.B. Rossi Borgo Roma;Oncology and Hematology Department, Oncology Unit, Piacenza General Hospital;Policlinico S. Orsola-Malpighi;Unit of Oncology, San Raffaele G. Giglio Institute;ARNAS Garibaldi Nesima - Catania;San Bortolo General Hospital;Department of Oncology, University & General Hospital;Medical Oncology, Hospital Casa Sollievo Della Sofferenza-San Giovanni Rotondo;Department of Oncology, Carpi and Mirandola Hospitals;ASST Cremona - Cremona;Clinical Institute Humanitas – Rozzano;Istituto di Ricerche Farmacologiche Mario Negri IRCCS;AUSL-IRCCS Clinical Cancer Center of Reggio Emilia - Reggio Emilia

关键词: pancreatic adenocarcinoma;    adjuvant;    first line;    prospective survey;    adherence to guidelines;   

DOI  :  10.1016/j.esmoop.2022.100777

学科分类：社会科学、人文和艺术（综合）

来源: BMJ Publishing Group

【 摘 要 】

Background Information about the adherence to scientific societies guidelines in the ‘real-world' therapeutic management of oncological patients are lacking. This multicenter, prospective survey was aimed to improve the knowledge relative to 2017-2018 recommendations of the Italian Association of Medical Oncology (AIOM).Patients and methods Treatment-naive adult patients with pancreatic adenocarcinoma were enrolled. Group A received adjuvant therapy, group B received primary chemotherapy, and group C had metastatic disease. The results on patients accrued until 31 October 2019 with a mature follow-up were presented.Results 75 years); 48% were female; 93% had Eastern Cooperative Oncology Group (ECOG) performance status (PS) score of 0 or 1; group A: 16%, group B: 30%; group C: 54%; 72% Nord, 13% Center, 15% South. In group A, guidelines adherence was 68% [95% confidence interval (CI) 59% to 76%]; 53% of patients received gemcitabine and 15% gemcitabine + capecitabine; median CA19.9 was 29 (range 0-7300; not reported 15%); median survival was 36.4 months (95% CI 27.5-47.3 months). In group B, guidelines adherence was 96% (95% CI 92% to 98%); 55% of patients received nab-paclitaxel + gemcitabine, 27% FOLFIRINOX, 12% gemcitabine, and 3% clinical trial; median CA19.9 was 337 (range 0-20220; not reported 9%); median survival was 18.1 months (95% CI 15.6-19.9 months). In group C, guidelines adherence was 96% (95% CI 94% to 98%); 71% of patients received nab-paclitaxel + gemcitabine, 16% gemcitabine, 8% FOLFIRINOX, and 4% clinical trial; liver and lung metastases were reported in 76% and 23% of patients, respectively; median CA19.9 value was 760 (range 0-1374500; not reported 9%); median survival was 10.0 months (95% CI 9.1-11.1 months).Conclusions The GARIBALDI survey shows a very high rate of adherence to guidelines and survival outcome in line with the literature. CA19.9 testing should be enhanced; nutritional and psychological counseling represent an unmet need. Enrollment to assess adherence to updated AIOM guidelines is ongoing.

【 授权许可】

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