Chemotherapy Regimens and Survival in Pancreatic Cancer-A Ten-Year Single Centre Overview.

BACKGROUND: During the last decade chemotherapy recommendations have changed for patients with pancreatic adenocarcinoma (PDAC) as novel regimens demonstrate better survival in selected cohorts. Herein we aim to, in a regional cohort, analyse therapy changes and possible survival benefits over a 10-year period. METHODS: Patients in the southern region of Sweden diagnosed with pancreatic cancer between 2010 and 2011 (Early group) and 2018 and 2019 (Late group), were enrolled from the Swedish Pancreatic Cancer Registry. Baseline characteristics and chemotherapy regimens were obtained from medical records. Resected and palliative patients were analysed separately. RESULTS: A total of 323 patients with PDAC were included: 81 resected and 242 palliative, 147 within the Early and 176 within the Late group. Both palliative and resected patients in the Late group were in general older with more comorbidities and more advanced disease, although few significant differences were found. The palliative patients in the Late group received more neoadjuvant, second-line and third-line treatment; however without impact on survival. Both groups demonstrated a clear transition towards combination therapies over the years. At 2 years after diagnosis overall survival was improved in the Late resected group with 82 versus 60%, adjusted p = 0.014. CONCLUSIONS: Since 2010 there has been a shift in chemotherapy treatment for pancreatic cancer patients towards the use of combination therapies. Our data demonstrates an increase in 2-year survival for resected patients, whereas corresponding figures for the palliative patients remain unchanged.