Dr Dotan on the Prognostic Value of QOL Assessments in Older Patients with Pancreatic Cancer

“The primary results were presented at [the 2024] ASCO [Annual Meeting], but here, we presented the analysis that focused on the quality of life and geriatric assessment factors at baseline and evaluated the correlation with their survival [for] patients on the trial. The study showed that there were very clear findings in the baseline assessment that had a strong correlation with survival, and that included function, nutrition and depression.”

Efrat Dotan, MD, executive medical director, Ann B. Barshinger Cancer Institute, Penn Medicine, Lancaster General Health, discusses findings from a secondary analysis of the phase 2 ECOG-ACRIN EA2186 (GIANT) trial (NCT04233866) evaluating gemcitabine plus nab-paclitaxel (Abraxane) vs 5-fluorouracil, leucovorin, and liposomal irinotecan (Onivyde) in older patients with treatment-naive metastatic pancreatic cancer.

Dotan notes that this analysis examined the correlation between baseline geriatric and quality-of-life (QOL) assessments with survival outcomes in this population. Functional status, nutritional status, and depression scores were identified as key predictive factors for survival, independent of ECOG performance status. Additionally, Dotan explains that all QOL measures correlated with overall survival (OS), highlighting the importance of baseline assessments in guiding treatment decisions.

Results presented at the 2025 Gastrointestinal Cancers Symposium demonstrated no significant difference in median OS between the treatment arms, with OS of 4.7 months (95% CI, 4.1-7.4) in the gemcitabine/nab-paclitaxel cohort and 4.4 months (95% CI, 3.1-8.9) in the fluoropyrimidine-based cohort (HR, 1.12; 95% CI, 0.76-1.66; P = .72). The median progression-free survival (PFS) was 3.0 months (95% CI, 1.9-4.3) vs 2.4 months (95% CI, 1.9-3.7), respectively (HR, 1.10; 95% CI, 0.79-1.53; P = .58). However, among patients who received at least 4 weeks of therapy, median OS improved to 8.0 months (95% CI, 5.9-10.0).

Dotan emphasizes that the QOL findings from the study support the integration of geriatric assessments into routine oncology practice to improve patient selection and optimize supportive care strategies. She highlights the potential to enhance outcomes by addressing baseline vulnerabilities, improving QOL, and providing tailored supportive care.