<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2341-4545</journal-id>
<journal-title><![CDATA[GE-Portuguese Journal of Gastroenterology]]></journal-title>
<abbrev-journal-title><![CDATA[GE Port J Gastroenterol]]></abbrev-journal-title>
<issn>2341-4545</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Gastrenterologia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2341-45452024000400038</article-id>
<article-id pub-id-type="doi">10.1159/000533178</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[The Initial Journey of Patients with Metastatic Pancreatic Cancer (PaCTO Project): A Nationwide Survey among Portuguese Specialist Physicians]]></article-title>
<article-title xml:lang="pt"><![CDATA[A jornada inicial dos doentes com cancro de pâncreas metastático (projeto PaCTO): um inquérito nacional a médicos especialistas portugueses]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barros]]></surname>
<given-names><![CDATA[Anabela G.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mansinho]]></surname>
<given-names><![CDATA[Hélder]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Couto]]></surname>
<given-names><![CDATA[Nuno]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Teixeira]]></surname>
<given-names><![CDATA[Manuel R.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tonin]]></surname>
<given-names><![CDATA[Fernanda S.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Francisco]]></surname>
<given-names><![CDATA[Rudolfo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Duarte-Ramos]]></surname>
<given-names><![CDATA[Filipa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
<xref ref-type="aff" rid="A0 "/>
<xref ref-type="aff" rid="Af1"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,University Hospital of Coimbra Department of Medical Oncology ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Garcia de Orta Hospital Hemato Oncology Department ]]></institution>
<addr-line><![CDATA[Almada ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Champalimaud Research Centre Champalimaud Clinical Centre Digestive Unit]]></institution>
<addr-line><![CDATA[Lisbon ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Porto Comprehensive Cancer Center Portuguese Oncology Institute of Porto (IPO Porto) Department of Laboratory Genetics]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,University of Porto School of Medicine and Biomedical Sciences (ICBAS) Cancer Genetics Group, IPO Porto Research Center (CI-IPOP)/RISE@CI-IPOP (Health Research Network)]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Federal University of Parana Pharmaceutical Sciences Postgraduate Program ]]></institution>
<addr-line><![CDATA[Curitiba ]]></addr-line>
<country>Brazil</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,Instituto Politécnico de Lisboa ESTeSL- Escola Superior de Tecnologia da Saúde H&amp;TRC-Health &amp; Technology Research Center]]></institution>
<addr-line><![CDATA[Lisbon ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,AstraZeneca Oncology-Medical Department ]]></institution>
<addr-line><![CDATA[Barcarena ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af9">
<institution><![CDATA[,University of Lisbon Faculty of Pharmacy Department of Pharmacy, Pharmacology and Health Technologies]]></institution>
<addr-line><![CDATA[Lisbon ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="A10">
<institution><![CDATA[,University of Lisbon Faculty of Pharmacy Research Institute for Medicine (iMed.ULisboa)]]></institution>
<addr-line><![CDATA[Lisbon ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="A11">
<institution><![CDATA[,Instituto de Saúde Pública da Universidade do Porto (ISPUP) Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR) EPIUnit]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2024</year>
</pub-date>
<volume>31</volume>
<numero>4</numero>
<fpage>38</fpage>
<lpage>48</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2341-45452024000400038&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2341-45452024000400038&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2341-45452024000400038&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  We aimed to characterize the initial healthcare journey of metastatic pancreatic ductal adenocarcinoma (mPDAC) patients in Portugal, including healthcare provision and factors affecting therapeutic decisions, namely BRCA mutations testing.  Methods:  This is a descriptive cross-sectional, web-based survey using a convenience sampling approach. Portuguese oncologists and pathologists that routinely work with mPDAC patients from the different geographical regions and settings were invited to participate in the study via email (December 2020). Descriptive statistical analyses were performed, with categorical variables reported as absolute and relative frequencies, and continuous variables with non-normal distribution as median and interquartile range (IQR) (Stata v.15.0).  Results:  Seventy physicians participated in the study (43 oncologists, 27 pathologists). According to the responses, a median of 28 patients per center (IQR 12-70) was diagnosed with PDAC in the previous year; 22 of them referring (IQR 8-70) to mPDAC. The pointed median time from patients&#8217; &#64257;rst hospital admission until disease diagnosis/staging is between 2 and 4 weeks. Endoscopic ultrasound with &#64257;ne-needle biopsy is available in most hospitals (86%). Around 50% of physicians request BRCA testing; the assessment of additional bio-markers besides BRCA is requested by 40% of professionals. Half of them stated that BRCA testing should be requested earlier-upon histological diagnosis, especially because the median time for results is of 4.0 weeks (IQR 4-8). PARP inhibitors such as olaparib, when available, would be the therapy of choice for most oncologists (71%) if no disease&#8217; progression occurs after 4 months. Treatments&#8217; selection is usually grounded on clinical criteria (e.g., performance status, liver function). Around 45% of patients use FOLFIRINOX/mFOLFIRINOX as the &#64257;rst-line therapy. Gemcitabine + nab-paclitaxel is used by 35% of patients as the second-line therapy.  Conclusions:  Physicians in Portugal support the increasing role of patient-tailored treatments in mPDAC, whose selection should be grounded on tumoral subtyping and molecular pro&#64257;ling. Further efforts to develop multidisciplinary teams, standardized clinical practice, and optimize the implementation of new target therapies are needed.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  Este estudo teve como objetivo caracterizar percurso inicial dos doentes com adenocarcinoma ductal pancreático metastático (ACDPm) em Portugal, incluindo a prestação de cuidados de saúde e determinação de fatores que afetam as decisões terapêuticas, nomeadamente o teste de mutações BRCA.  Métodos:  Trata-se de um estudo descritivo transversal (web-based) usando uma abordagem de amostragem por conveniência. Médicos oncologistas e anatomopatologistas portugueses dedicados ao ACDPm e de diferentes regiões geográ&#64257;cas e instituições foram convidados a participar do estudo por email (Dez-2020). Foram realizadas análises estatísticas descritivas, com variáveis categóricas relatadas como frequências absolutas e relativas, e variáveis contínuas com distribuição não-normal como mediana e intervalo interquartil (IIQ) (Stata v.15.0).  Resultados:  Setenta médicos participaram do estudo (43 oncologistas, 27 patologistas). De acordo com as respostas, uma mediana de 28 doentes por centro (IIQ 12-70) foi diagnosticada com ACDP no ano anterior; 22 deles (IIQ 8-70) referentes a ACDPm. O tempo médio desde a primeira admissão hospitalar dos doentes até o diagnóstico/estadiamento da doença foi entre 2-4 semanas. A ultrassonogra&#64257;a endoscópica com biópsia por agulha &#64257;na é realizada pela maioria dos hospitais (86%). Aproximadamente 50% dos médicos referem solicitar o teste BRCA; a avaliação de biomarcadores adicionais além do BRCA é solicitada por 40% dos pro&#64257;ssionais. Metade dos médicos assume que o teste BRCA deveria ser solicitado mais precocemente - durante o diagnóstico histológico, principalmente porque o tempo médio para obtenção do resultado é de 4,0 semanas (IIQ 4-8). Os inibidores PARP, como o olaparibe, quando disponíveis, seriam a terapia de escolha para a maioria dos oncologistas (71%) caso não haja progressão da doença após quatro meses. A seleção dos tratamentos é usualmente baseada em critérios clínicos (por exemplo, performance status, função hepática). Em cerca de 45%dos doentes é utilizado FOLFIRINOX/mFOLFIRINOX como terapia de primeira linha. Um esquema com Gemcitabina+ nabpaclitaxel é usado em 35% dos doentes como terapia de segunda linha.  Conclusões:  Os médicos em Portugal apoiam o papel crescente do tratamento individualizado no ACDPm, cuja seleção deve ser baseada na subtipagem tumoral e no per&#64257;l molecular. São necessários mais esforços para capacitar as equipas multi-disciplinares, desenvolver práticas clínicas padronizadas e otimizar a implementação de novas terapias-alvo.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Pancreatic neoplasms]]></kwd>
<kwd lng="en"><![CDATA[Immunotherapy]]></kwd>
<kwd lng="en"><![CDATA[Cross-sectional studies]]></kwd>
<kwd lng="en"><![CDATA[Surveys and Questionnaires]]></kwd>
<kwd lng="pt"><![CDATA[Cancro pancreático]]></kwd>
<kwd lng="pt"><![CDATA[Imunoterapia]]></kwd>
<kwd lng="pt"><![CDATA[Estudo transversal]]></kwd>
<kwd lng="pt"><![CDATA[Questionários]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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