Pancreatic enzyme replacement therapy (PERT) led to an improved probability of disease control and a greater benefit in Patient-Generated Subjective Global Assessment (PG-SGA) score vs no PERT in patients with unresected pancreatic cancer, according to data presented at the 2021 Gastrointestinal Cancers Symposium.

Investigators of the retrospective study used the Virginia Mason pancreatic cancer database (Virginia Mason Hospital and Medical Center, Seattle, WA) to assess 344 patients with unresected pancreatic cancer. The patients, who otherwise had no prior history of treatment for pancreatic cancer per study eligibility criteria, were stratified by PERT versus non-PERT use.

PERT was given based on abnormal fecal elastase and/or clinical symptoms (eg, diarrhea) per PG-SGA score. Patients were considered to have received PERT if the intervention was administered for most of the initial assessment period to first follow-up (>30 days). Analysis was based on an “intent-to-treat” basis without compliance validation.


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Of the 344 patients, 207 (60%) received PERT and 137 (40%) did not. Patient characteristics were similar in the PERT and non-PERT groups; however, the mean baseline PG-SGA score was higher in the PERT group compared with the non-PERT group (10.9 vs 8.2; P <.01).

The median time from the first day of treatment to the first reassessment was 60 days. Seventy-nine percent of patients completed the PG-SGA prior to the first day of treatment and 97%, within 2 weeks of the first day of treatment. The change from baseline PG-SGA was favorable overall and in all patient subsets; however, greater improvement was observed in the PERT group versus the non-PERT group (P <.001) and in disease-controlled versus non-disease-controlled group (P <.05).

At the first reassessment, the number of patients that achieved disease control (ie, regression/stable disease) was 87% in the PERT group vs 79% in the non-PERT group (P <.04).

“PERT versus non-PERT patients were similar with respect to basic clinical or nutritional parameters, such as, body mass index, albumin,” Vincent J. Picozzi, MD, MMM, said during the poster presentation. “Despite having more adverse baseline PG-SGA scores, PERT patients were statistically superior to non-PERT patients with respect to both frequency of disease control and magnitude of PG-SGA response during initial [treatment]. Further investigation of the detail involving PERT usage and clinical outcomes in nonresected pancreatic cancer is warranted.”

Disclosures: Some of the study authors disclosed financial relationships with the pharmaceutical industry and/or the medical device industry. For a full list of disclosures, please refer to the original study. This clinical trial was supported by Abbvie.

Reference

Picozzi VJ, Hawari R, Najjar A, Harb DE, Kort JJ, Mandelson MT. Impact of pancreatic enzyme replacement therapy (PERT) on clinical outcomes in nonresected pancreatic cancer (PC): initial results. Poster presented at: 2021 Gastrointestinal Cancers Symposium; January 15-17, 2021. Abstract 400.

This article originally appeared on Cancer Therapy Advisor