A new study, published by the Journal of Personalized Medicine, highlights AccessHope’s clinical impact on 94 cases of pancreatic adenocarcinoma (reviewed between August 2019–December 2022). The findings show that in 94% of cases, the subspecialist provided recommendations anticipated to improve outcomes. Gaps in care were more pronounced in patients with non-metastatic pancreatic cancer.
Study Population
Of these 94 pancreatic cancer cases:
- 34% of were being treated at an academic center and 66% at a local setting
- 55% of the cases were men
- Median patient age was 58
- 63% of patients had cancer that had metastasized
- 37% of patients had localized and locally advanced disease
Study results
AccessHope National Cancer Institute (NCI) subspecialists agreed completely with the treating oncologist's plan, in only 6% of the cases, offering no additional recommendations. In 94% of the cases, cancer subspecialists offered enhancements to the treating oncologists’ plan. The three most common recommendations across these cases were for germline testing, somatic testing , and for the integration of supportive care services. The study revealed:
- Disagreed with current care approaches in 19% of cases, which included reasons like a lack of multidisciplinary evaluation prior to initiating treatment
- Offered enhancements to existing care plans in 75% of cases, most frequently recommending germline testing, somatic testing, or the integration of supportive care services
- Suggested care delivery improvements to cancer-directed therapy (75%), member well-being (32%), and downstream benefit to the family due to germline testing (37%)
Major gaps in care
We evaluated the care received by patients treated at academic centers vs. those treated at local practices by looking at access to comprehensive care, including germline and somatic testing, as well as supportive and palliative care services.
- 59% of the cases had completed or initiated germline genetic testing, with no difference in the completion of this test between academic and community physicians
- 20% of the cases had documentation for referral or use of palliative and supportive care services. There was no significant difference between academic practices and private practices for delivery of palliative care.
Conclusion:
While many of the patients with pancreatic cancer were receiving aggressive therapy (as evidenced by choice of chemotherapy), they lacked a patient-centered care approach or support for the aggressive nature of their disease. This could translate to lower quality of life and higher chances of experiencing toxicities. Lastly, patients with non-metastatic disease who need multidisciplinary care had larger gaps in care compared to those with metastatic disease.
Acknowledgements
The study was led by Dr. Afsaneh Barzi with contributions from additional AccessHope colleagues and experts from City of Hope and Dana-Farber Cancer Institute.
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