Racial and ethnic differences in pancreatic cancer survival and treatment at a high-volume center.

662 Background: Survival disparities by race and ethnicity in pancreatic cancer are often attributed to delayed access to specialized centers and differential treatment receipt. Whether these patterns persist among patients receiving care at high-volume centers remains unclear. Methods: We identified patients with pancreatic adenocarcinoma diagnosed from 2016-2024 who received chemotherapy or radiation or underwent a curative-intent pancreatectomy at an NCI-designated Comprehensive Cancer Center. Data were extracted from the institutional cancer registry, pharmacy database, and electronic health record and harmonized using Palantir Foundry. Treatment receipt by self-reported race and ethnicity was compared using chi-squared tests corrected for multiple comparisons. Cox models for overall survival (OS) and time to treatment were adjusted for age, performance status, stage at diagnosis, comorbidities, and treatment-specific variables. Results: Among 3249 patients (median follow-up 33.1 months), median OS from diagnosis across all stages was 20.7 months for non-Hispanic White (NHW), 18.6 for Hispanic, 26.6 for Asian, and 17.4 for Black patients ( p