BACKGROUND Pancreatic cancer represents the third leading cause of US cancer deaths, with median survival <1 year. The goal of this study was to describe systemic treatments, healthcare utilization and costs, and overall survival among patients with unresectable/metastatic disease. METHODS This study used healthcare claims for commercial and Medicare Advantage enrollees diagnosed with pancreatic adenocarcinoma (at index date) during January 01 2010 to 31 May 2017. Included patients were aged ≥18 years, with continuous 6-month preindex enrollment. Patients were excluded by resectable disease, another primary cancer, or pregnancy. Cohorts were based on first-line (LOT1) chemotherapy regimen. RESULTS Overall, 12 978 patients (mean age 70 years, 51% male) were included, among which 5610 (43%) received chemotherapy. Of those, 23% received gemcitabine monotherapy, 22% gemcitabine-nab paclitaxel, 22% FOLFIRINOX, 3% FOLFOX, and 29% received other regimens. Mean LOT1 duration was 112 days; 60% did not undergo subsequent lines of therapy. Moreover, 50% of patients had an emergency room visit and 45% were hospitalized during LOT1. Among treated and untreated patients, mean total 6-month costs were $52 101. We found that patients receiving FOLFIRINOX had the highest costs, whereas those who received gemcitabine monotherapy had the lowest. Median overall survival (mOS) was 335 days with any first-line treatment. FOLFIRINOX-treated patients had the highest mOS (492 days), whereas gemcitabine monotherapy-treated patients had the lowest (223 days). CONCLUSIONS A large proportion (57%) of patients with unresectable/metastatic pancreatic cancer did not receive chemotherapy. Healthcare costs were higher for fluorouracil-based regimens, while lower for gemcitabine-based regimens. Survival rates were within expectations for advanced pancreatic cancer.

中文翻译：

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胰腺癌的治疗模式和结果：回顾性索赔分析。

背景胰腺癌是美国癌症死亡的第三大原因，中位生存期<1 年。本研究的目的是描述不可切除/转移性疾病患者的全身治疗、医疗保健利用和成本以及总生存期。方法 本研究对 2010 年 1 月 1 日至 2017 年 5 月 31 日期间诊断为胰腺癌（索引日期）的商业和 Medicare Advantage 登记者使用医疗保健索赔。纳入的患者年龄≥18 岁，连续 6 个月的索引前登记。患者被可切除的疾病、另一种原发癌症或怀孕排除在外。队列基于一线（LOT1）化疗方案。结果共纳入12 978例患者（平均年龄70岁，男性51%），其中5610例（43%）接受化疗。那些，23% 接受吉西他滨单药治疗，22% 接受吉西他滨-nab 紫杉醇治疗，22% 接受 FOLFIRINOX，3% 接受 FOLFOX，29% 接受其他方案。平均 LOT1 持续时间为 112 天；60% 未接受后续治疗。此外，在 LOT1 期间，50% 的患者曾就诊于急诊室，45% 的患者住院。在接受治疗和未接受治疗的患者中，6 个月的平均总费用为 52 101 美元。我们发现接受 FOLFIRINOX 的患者费用最高，而接受吉西他滨单药治疗的患者费用最低。任何一线治疗的中位总生存期 (mOS) 为 335 天。FOLFIRINOX 治疗患者的 mOS 最高（492 天），而吉西他滨单药治疗患者的 mOS 最低（223 天）。结论 大部分 (57%) 不可切除/转移性胰腺癌患者未接受化疗。基于氟尿嘧啶的方案的医疗保健成本较高，而基于吉西他滨的方案的医疗保健成本较低。生存率在晚期胰腺癌的预期范围内。