Abstract 5957: A real-world study for cost-effectiveness analysis of nanoliposomal irinotecan in patients with pancreatic adenocarcinoma

Abstract Background: Systemic chemotherapy plays a crucial role in pancreatic adenocarcinoma (PAC), not only as palliative chemotherapy for unresectable PAC, but also as (neo-)adjuvant chemotherapy for (borderline) resectable PAC. Recently, nano-liposomal irinotecan plus 5-fluorouracil/leucovorin (nal-IRI/5-FU/LV) showed a survival benefit in the global phase 3 NAPOLI-1 trial. However, there is a paucity of studies that have evaluated the effectiveness and cost analysis of nal-IRI in the entire treatment course of PAC. Therefore, this study aimed to evaluate the effectiveness and cost of treatment according to exposure to nal-IRI in the management of PC using an electronic health record data. Methods: We analyzed the effectiveness and cost according to the exposure of nal-IRI/5-FU/LV treatment during follow-up. Effectiveness was assessed by overall survival (OS) and direct medical costs including costs of imaging or laboratory tests, administration of chemotherapy, surgery, or radiotherapy, supportive care, management of adverse events during inpatient, outpatient, and emergency department were included in this study. Propensity score matching was used to adjust for potential differences in patient characteristics between nal-IRI group and non-liposomal irinotecan group. We defined the incremental cost-effectiveness ratio as the difference in mean total medical costs (per patient) divided by the difference in median OS between two groups. Results: A total of 1, 734 patients diagnosed with PAC were screened, and 705 patients who received at least one cycle of chemotherapy were included in the analysis. Median OS was significantly longer in the nal-IRI group compared to the non-liposomal irinotecan group (28.0 months vs. 18.3 months, P = 0.011). Patients in the nal-IRI group had more hospital visits and admissions during follow-up, the average total cost per patient was was higher in the nal-IRI group ($61, 430 vs $39, 129). The incremental cost-effectiveness ratio was $2, 787 per month of median survival gained ($33, 285 per life-year gained). Conclusions: In this real-world retrospective study, patients treated with nal-IRI/5-FU/LV showed longer OS and the incremental cost-effectiveness ratio was acceptable given the poor prognosis of PAC. Funding: This work was supported in part by Servier No. 2152460) and in part by the National Cancer Center, Korea (No. 2310280). Citation Format: Jung Won Chun, Jang Won Lee, Dong Kee Jang, Yoon Suk Lee, Jong-Chan Lee, Jin-Hyeok Hwang, Byeong-Gon Kim, Sung Jun Kim, Gyuryang Park, Tae Young Kim, Young Ae Kim, Sang Myung Woo. A real-world study for cost-effectiveness analysis of nanoliposomal irinotecan in patients with pancreatic adenocarcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 5957.