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. 2025 Jan;21(2):241-260.
doi: 10.1080/14796694.2024.2435253. Epub 2024 Dec 8.

Real-world clinical outcomes and economic burden of metastatic pancreatic ductal adenocarcinoma: a systematic review

Paul Cockrum  1 , Syvart Dennen  2 , Audrey Brown  2 , Jonathon Briggs  2 , Ravi Paluri  3
Affiliations

Real-world clinical outcomes and economic burden of metastatic pancreatic ductal adenocarcinoma: a systematic review

Paul Cockrum et al. Future Oncol. 2025 Jan.

Abstract

Aims: This systematic review summarizes real-world clinical outcomes and economic burden of first-line FOLFIRINOX (FFX)/modified FFX (mFFX) and nab-paclitaxel plus gemcitabine (GnP) in metastatic pancreatic ductal adenocarcinoma in the US.

Methods: Embase and MEDLINE were searched for materials published since 2014; citations were reviewed in a two-step process. Included studies were qualitatively synthesized.

Results: Searches yielded 2,528 citations; 29 were included (17 clinical studies/12 economic studies). In 9/17 clinical studies, median overall survival (mOS) ranged from 4.7 months to 11.4 months for FFX/mFFX, with the unweighted median of the estimates within this range being 9.2 months; for GnP mOS ranged from 3.6 to 9.8 months, and the unweighted median of the estimates was 6.9 months. In 8/17 studies, grade 3/4 anemia, neutropenia, and thrombocytopenia were the most commonly reported adverse events. Across economic burden studies, total costs were similar between the 2 groups. Outpatient, supportive care, and granulocyte colony-stimulating factor costs were higher for the FFX generic regimen, and chemotherapy costs were higher for the GnP branded regimen.

Conclusions: Real-world OS in FFX- and GnP-treated populations was shorter than that in clinical trials, and total costs of FFX and GnP were similar, but with differences in cost components.

Keywords: FOLFIRINOX; Pancreatic adenocarcinoma; adverse events; costs and cost analysis; nab-paclitaxel plus gemcitabine; overall survival; real-world evidence.

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Conflict of interest statement

Paul Cockrum reports current employment and equity holder in Ipsen Biopharmaceuticals, Inc. Syvart Dennen, Audrey Brown, and Jonathon Briggs are all employees of Genesis Research Group, which received consulting fees from Ipsen Biopharmaceuticals Inc. Ravi Paluri has received an honorarium for consultation and speaking from Ipsen Biopharmaceuticals Inc. and Seagen and for consultation from Exelixis. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Medical writing and editorial support were provided by Jacqueline Michel and Henry Blanton of Genesis Research Group, Hoboken, NJ, US, which was funded by Ipsen Biopharmaceuticals Inc.

Figures

Figure 1.
Figure 1.
Preferred reporting items for systematic reviews and meta-analyses diagram; selection of studies for the clinical outcomes and adverse events (a) and the economic outcomes (b).
Figure 2.
Figure 2.
Overall survival in FOLFIRINOX or nab-paclitaxel plus gemcitabine treated patients with metastatic pancreatic ductal adenocarcinoma.
Figure 3.
Figure 3.
Mean total costs among patients with metastatic pancreatic ductal adenocarcinoma treated with FOLFIRINOX or nab-paclitaxel plus gemcitabine.
Figure 4.
Figure 4.
Mean total costs per patient per month among patients with metastatic pancreatic ductal adenocarcinoma treated with FOLFIRINOX or nab-paclitaxel plus gemcitabine.
Figure 5.
Figure 5.
Mean chemotherapy and other costs among patients with metastatic pancreatic ductal adenocarcinoma treated with FOLFIRINOX or nab-paclitaxel plus gemcitabinea.
See this image and copyright information in PMC

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