Epidemiological characteristics of gastric and pancreatic cancers in Latin America: GASPAR (LACOG 0222) study.
Authors: Peixoto Renata D'Alpino , Jesus Victor Hugo Fonseca , Diniz Gomes Diogo Bugano , Yossen David , Weschenfelder Rui Fernando , Felismino Tiago Cordeiro , Esteso Federico , Bonilla Carlos Eduardo , Kruschewsky Coutinho Araujo Anelisa , Dias Jr Antonio Soares , Freile Berenice , Cabalheiro Tainá , Gössling Gustavo , Barrios Pablo 
Published: January 2025

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Background:
Gastric (GC) and pancreatic cancer (PC) have poor prognosis representing major public health challenges, particularly in Latin America. Real-world data are limited. GASPAR (LACOG 0222) study addresses this gap by creating a multicenter database to analyze epidemiological, clinical, and pathological data, treatments, and outcomes for patients (pts) with GC and PC.
Methods:
This retrospective and prospective observational cohort study enrolled pts from 7 research sites in 3 LATAM countries with metastatic/locally advanced not amenable to curative intent GC (Cohort A) and PC (Cohort B) diagnosed from January 2019. Data were collected from medical records. (
NCT05924789
).
Results:
201 pts were included: 122 with GC (Cohort A) and 79 with PC (Cohort B). 150 (75%) from Brazil, 29 (14%) from Argentina, and 22 (11%) from Colombia. Median age at diagnosis was 69 years (IQR 57-78), 70 (35%) had history of tobacco use, and 153 (76%) were covered by private healthcare (Table). In Cohort A (GC), HER2 status was assessed in 105 (86%) pts, with 12 (11%) HER2-positive; PD-L1 was tested in 87 (71%): 55 (63%) had ≥1% expression and 28% had ≥10%; all 88 (72%) patients who had MMR tested had MMR proficient. First-line treatment was given to 107 (88%) pts: 78 (73%) chemotherapy (CT) alone (FOLFOX in 43 [40%]; FLOT in 16 [15%]); 23 (21%) CT + immunotherapy; and 7 (7%) CT + anti-HER2. Only 59 (48%) pts received second-line treatment and 31 (25%) third-line. With median follow-up (mFUP) of 29 months (CI95% 18.2-50.4), the median progression-free survival (mPFS) at first-line was 5.6 months (CI95% 4.2-6.3) and the median overall survival (mOS) was 11.2 months (CI95% 9.2-14.1). In Cohort B (PC), 67 (85%) pts received first-line treatment: 41 (61%) FOLFIRINOX and 14 (21%) gemcitabine-nab-paclitaxel. 27 (34%) pts received second-line treatment and 10 (13%) third-line. With mFUP of 21 months (CI95% 15.6-NR), the mPFS at first-line was 5.4 months (CI95%3.9-6.4) and the mOS was 10.2 months (CI95% 8.6-13.1).
Conclusions:
The GASPAR study provides valuable real-world data on GC and PC in Latin America. Notably, the mPFS in both cohorts was slightly lower than historical controls for first-line treatments, while the mOS was similar, suggesting earlier disease progression despite comparable overall survival. Improved therapeutic strategies and healthcare access are needed to enhance outcomes for these populations.
Clinical trial information: NCT05924789
.

Clinical characteristics.

Characteristic
GC (Cohort A)N=122
PC (Cohort B)N=79

Median age (IQR), yr
66 (51–78)
71.0 (61–79)

Male – n. (%)
58 (56)
40 (51)

Race – n. (%)

White
67 (55)
71 (90)

American Indian or Alaska Native
15 (12)
6 (8)

Black
7 (6)
0

Other
7 (6)
0

Not reported
26 (21)
2 (2)

Disease status at study entry

Locally advanced disease
4 (3)
14 (18)

Metastatic disease
118 (97)
65 (82)

ECOG status in first-line advanced disease – n. (%)

0-1
75 (70)
45 (67)

≥ 2
13 (12)
3 (4.5)

Not reported
19 (17.8)
19 (28.4)