OBJECTIVES : Racial disparities persist in outcomes for patients with pancreatic cancer in the United States, with Black or African American patients having higher age-adjusted incidence and mortality than White patients. Similarly, results from the pivotal phase 3 study, NAPOLI-1, and recent literature suggest that participants of East Asian ethnic origin experience better outcomes than other ethnic groups with liposomal irinotecan+5-fluorouracil/leucovorin following gemcitabine. This study seeks to describe clinical characteristics and treatment outcomes based on race.

METHODS : This retrospective observational study utilized the Flatiron Health EHR-derived de-identified database from over 280 cancer clinics in the US. Data were analyzed for adult patients with mPDAC treated with liposomal irinotecan-based regimens between January 2015 and February 2020. Patients were stratified based on their self-reported race. Median overall survival (OS) from treatment initiation was derived using Kaplan-Meier analysis.

RESULTS : Of the included 608 patients (median age 68 years (y), IQR: 61-74) with mPDAC and treated with a liposomal irinotecan-based regimen, 448 patients (73.7%) were White, 48 patients (7.9%) were Black or African American, 13 (2.1%) were Asian, and 99 (16.3%) were of other race or the data were missing. White patients had a median age at metastatic diagnosis of 69y (IQR: 61–74), Black patients, 64y (60-71), and Asian patients 65y (63-72). ECOG scores of 0-1 were reported for 61.6% of White patients, 58.3% of Black patients, and 61.5% of Asian patients. Overall, median OS was 4.7 months (95% CI: 4.2–5.4). Median OS was 4.6 months 4.1–5.6) among White patients, 3.8 months (3.1–5.6) among Black patients, and 12 months (3.4–NR) among Asian patients.

CONCLUSIONS : This analysis found racial disparities may persist in survival outcomes among patients with mPDAC treated with liposomal irinotecan-based regimens. Further studies are needed to characterize and understand the biological and socio-economic factors contributing to these disparate outcomes.