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News
Two large real-world studies reveal a dramatic divide in systemic therapy use for metastatic pancreatic cancer — 72% of Dutch patients went untreated vs. just 33.5% in the US. Patient preferences, healthcare delivery differences, and the types of data captured likely explain the gap. Experts caution against reading the numbers as a straightforward head-to-head comparison.
Two major real-world studies — one from the Netherlands and one from the US — reveal strikingly different rates of systemic therapy use in metastatic pancreatic cancer. The Dutch nationwide registry study (13,756 patients, 2015–2023) found that 72% of patients never received systemic treatment, while the US Flatiron Health EHR study (9,439 patients, 2019–2024) found only 33.5% went untreated — nearly a mirror image of each other.
But experts say it's not an apples-to-apples comparison. The Dutch registry captured all diagnosed patients — including those who never saw an oncologist — while the US database largely reflects patients already engaged with oncology practices, a group more likely to pursue treatment. Cultural differences in patient preferences also play a role: 39% of Dutch patients declined treatment based on personal or family choice, a rate far higher than what US oncologists typically see.
By the Numbers:
Why it matters: These findings highlight how healthcare system design, data collection methods, and patient values all shape treatment decisions — and underscore the importance of individualized, transparent conversations about prognosis and quality of life in pancreatic cancer care.
