Background: Based on a randomized clinical trial, MPACT, nab-P+G had superior overall survival (OS) compared to G for the treatment of advanced PAC, but limited data is available comparing the effectiveness of these treatment options in a real-world setting. The objective of this study is to compare treatment patterns of patients (pts) receiving nab-P+G versus G for first-line treatment of MPAC. Methods: A retrospective cohort study was performed using fully de-identified data from a nationally representative electronic medical record platform of 1,300 community oncologists. Pts diagnosed with MPAC between September 2013 and October 2014 and received 1^st line therapy with either nab-P+G or G were included in the analysis. We calculated the median time to treatment discontinuation (TTD) and estimated survival (ES), a proxy for OS, using the Kaplan Meier method, and assessed incidence of adverse events (AEs) and supportive care usage. We carried out a sensitivity analysis on patients aged 70 and above for TTD and ES. Results: Out of 851 pts, 168 met eligibility criteria (nab-P+G, n = 122; G, n = 46). Pts in the nab-P+G arm were younger (mean age 67.0 v 72.0, p < 0.01) and mostly males (60% v 44%). Other baseline characteristics were comparable. nab-P+G pts had a statistically significant longer median TTD (3.4 v 2.2 mos; p < 0.01) and median ES (8.6 v 5.3 mos, p = 0.03). For pts > 70, TTD and ES were longer in the nab-P+G group compared to the G group (3.7 mos v 2.1 mos, p = 0.02; 8.2 v 5.2 mos, p = 0.02). nab-P+G pts had fewer AEs-related to discontinuation (18% v 26%); but utilized more doses of G-CSF (2.02 v 0.73, p < 0.01), ESA (0.90 v 0.54, p < 0.01) and steroids (7.89 v 0.58 doses, p < 0.01) per 100 days compared to pts on G. Conclusions: Similar to the benefit demonstrated in MPACT trial comparing nab-P+G with G,patients receiving nab-P+G experienced significantly longer median TTD and ES in this real-world analysis vs G. More supportive care may have been used in the nab-P+G group due to longer treatment duration.