Investigation of Treatment‐Related Disparities in Metastatic Pancreatic Cancer Patients Using Real‐World Data

TL;DR

This study finds racial disparities in the initial treatment timing for metastatic pancreatic cancer but no differences in overall survival.

Contribution

The study identifies a modest racial disparity in time to first treatment for mPDAC using real-world data.

Findings

Black patients had a significant delay in time to first treatment compared to White patients in the first 2 months after diagnosis.

No significant differences in receipt of first-line therapy or overall survival were observed by race.

Disparities in treatment timing were not sustained beyond 2 months post-diagnosis.

Abstract

Racial disparities exist in the overall treatment of patients with metastatic pancreatic adenocarcinoma (mPDAC). Compared to White patients, patients of color are less likely to undergo surgical resection for early‐stage disease and receive chemotherapy. This study explored the time to first treatment (T2FT), receipt of standard guideline‐concordant first‐line therapies, and overall survival in an mPDAC population by race/ethnicity.

Utilizing real‐world United States data from the Flatiron Health electronic health record (EHR) derived, deidentified database, T2FT was defined as the difference between the diagnosis date of mPDAC and the initiation of first‐line systemic anticancer therapy in days; receipt of standard‐guideline concordant first‐line therapy was defined based on the National Comprehensive Cancer Network guidelines. We assessed disparities in T2FT and overall survival by race using Kaplan–Meier curves with log‐rank tests and Cox proportional hazards regression models.

In the study population of interest, there was a significant difference in T2FT for Black compared to White patients. This effect is attributable to the first 2 months following diagnosis. There was no evidence of a difference by race after 2 months. Receipt of first‐line therapy and the median number of standard‐guidelines therapies did not significantly differ by race/ethnicity.

Our findings suggest that there is a modest difference in T2FT by race/ethnicity in the initial time period following diagnosis of mPDAC, but no reported difference in overall survival. Additional studies using a larger, more diverse cohort of patients are recommended to better understand the effects of race/ethnicity on the treatment and survival of patients with mPDAC.

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