Sex, Gender and Age Differences in Treatment Allocation and Survival of Patients With Metastatic Pancreatic Cancer: A Nationwide Study.

Background

Biological sex, gender and age have an impact on the incidence and outcome in patients with metastatic pancreatic cancer. The aim of this study is to investigate whether biological sex, gender and age are associated with treatment allocation and overall survival (OS) of patients with metastatic pancreatic cancer in a nationwide cohort.

Methods

Patients with synchronous metastatic pancreatic cancer diagnosed between 2015 and 2019 were selected from the Netherlands Cancer Registry (NCR). The association between biological sex and the probability of receiving systemic treatment were examined with multivariable logistic regression analyses. Kaplan Meier analyses with log-rank test were used to describe OS.

Results

A total of 7470 patients with metastatic pancreatic cancer were included in this study. Fourty-eight percent of patients were women. Women received less often systemic treatment (26% vs. 28%, P=0.03), as compared to men. Multivariable logistic regression analyses with adjustment for confounders showed that women ≤55 years of age, received more often systemic treatment (OR 1.82, 95% CI 1.24-2.68) compared to men of the same age group. In contrast, women at >55 years of age had a comparable probability to receive systemic treatment compared to men of the same age groups. After adjustment for confounders, women had longer OS compared to men (HR 0.89, 95% CI 0.84-0.93).

Conclusion

This study found that women in general had a lower probability of receiving systemic treatment compared to men, but this can mainly be explained by age differences. Women had better OS compared to men after adjustment for confounders.

Informations de copyright

Copyright © 2022 Pijnappel, Schuurman, Wagner, de Vos-Geelen, Geest, de Groot, Koerkamp, de Hingh, Homs, Creemers, Cirkel, van Santvoort, Busch, Besselink, van Eijck, Wilmink and van Laarhoven.

Déclaration de conflit d'intérêts

AW has received non-financial support from Roche and has received institutional support from Abbvie, Daichi Sankyo, IPSEN, Lily, Merck, MSD, Pierre Fabre, Servier. JV-G has received non-financial support from Servier, and has received institutional research funding from Servier. All outside the submitted work. JWW has served as a consultant for Shire, Servier and Celgene and reports grands from Servier, Halozyne, Novartis, Celgene, Astra Zeneca, Pfizer, Roche, Amgen and Merck. HWMvL has served as a consultant for BMS, Celgene, Lilly, Merck, Nordic, and Servier and has received unrestricted research funding from Bayer, BMS, Celgene, Lilly, Merck Serono, MSD, Nordic, Philips, Roche and Servier. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.