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Impact of the COVID-19 Pandemic on Management of Patients with Metastatic Pancreatic Ductal Adenocarcinoma in the United States.
Paluri, Ravi; Laursen, Ashley; Gaeta, Joseph; Wang, Shu; Surinach, Andy; Cockrum, Paul.
  • Paluri R; Wake Forest Baptist Health, Winston-Salem, NC, USA.
  • Laursen A; Ipsen, Cambridge, MA, USA.
  • Gaeta J; Ipsen, Cambridge, MA, USA.
  • Wang S; Genesis Research, Hoboken, NJ, USA.
  • Surinach A; Genesis Research, Hoboken, NJ, USA.
  • Cockrum P; Ipsen, Cambridge, MA, USA.
Oncologist ; 27(6): e518-e523, 2022 06 08.
Article in English | MEDLINE | ID: covidwho-1740952
ABSTRACT

BACKGROUND:

The purpose of this study was to understand how the COVID-19 pandemic has affected health care patterns and outcomes for patients diagnosed with metastatic pancreatic ductal adenocarcinoma (mPDAC) in 2020 compared with those diagnosed with mPDAC in 2019. PATIENTS AND

METHODS:

We used the Flatiron Health database to identify adults diagnosed with mPDAC from March 1 to September 30, 2019 (pre-COVID-19 cohort) and March 1 to September 30, 2020 (post-COVID-19 cohort). Between-cohort comparisons included demographic and clinical characteristics and year-over-year data for diagnosis of mPDAC, newly treated patients, time to and types of first-line therapy, and adverse events (AEs) during first-line therapy. Overall survival (OS) and milestone survival rates were evaluated. Kaplan-Meier methods were used to assess OS.

RESULTS:

Pre-COVID-19 (n = 923) and post-COVID-19 (n = 796) cohorts had similar baseline demographic characteristics. A smaller proportion of patients in the pre-COVID-19 cohort were initially diagnosed with stage IV disease versus the post-COVID-19 cohort (62.2% vs 69.7%). Between 2019 and 2020, there was a 13.8% decrease in diagnosis of mPDAC and a 13.0% decrease in newly treated patients. Median (interquartile range) times to first-line treatment were similar (21 [13-40] and 19 [12-32] days). Median OS (months) was significantly longer in the pre-COVID-19 cohort (8·4 [95% CI 7·5, 9·0]) versus the post-COVID-19 cohort (6·1 [95% CI 5·4, 6·9]; P < .001). Survival rates were higher in the pre-COVID-19 versus post-COVID-19 cohorts.

CONCLUSIONS:

During the pandemic, patients were initially diagnosed with PDAC at more advanced stages. While patients in both cohorts appeared to receive similar care, survival outcomes were adversely affected.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pancreatic Neoplasms / Adenocarcinoma / Carcinoma, Pancreatic Ductal / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Humans Country/Region as subject: North America Language: English Journal: Oncologist Journal subject: Neoplasms Year: 2022 Document Type: Article Affiliation country: Oncolo

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pancreatic Neoplasms / Adenocarcinoma / Carcinoma, Pancreatic Ductal / COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Humans Country/Region as subject: North America Language: English Journal: Oncologist Journal subject: Neoplasms Year: 2022 Document Type: Article Affiliation country: Oncolo