Adjuvant chemotherapy in elderly patients with pancreatic cancer

Nagrial, A.M. et al. (2014) Adjuvant chemotherapy in elderly patients with pancreatic cancer. British Journal of Cancer, 110(2), pp. 313-319. (doi:10.1038/bjc.2013.722) (PMID:24263063) (PMCID:PMC3899761)

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Abstract

background: Adjuvant chemotherapy improves survival for patients with resected pancreatic cancer. Elderly patients are under-represented in Phase III clinical trials, and as a consequence the efficacy of adjuvant therapy in older patients with pancreatic cancer is not clear. We aimed to assess the use and efficacy of adjuvant chemotherapy in older patients with pancreatic cancer.<p></p> methods: We assessed a community cohort of 439 patients with a diagnosis of pancreatic ductal adenocarcinoma who underwent operative resection in centres associated with the Australian Pancreatic Cancer Genome Initiative.<p></p> results: The median age of the cohort was 67 years. Overall only 47% of all patients received adjuvant therapy. Patients who received adjuvant chemotherapy were predominantly younger, had later stage disease, more lymph node involvement and more evidence of perineural invasion than the group that did not receive adjuvant treatment. Overall, adjuvant chemotherapy was associated with prolonged survival (median 22.1 vs 15.8 months; P<0.0001). Older patients (aged greater than or equal to70) were less likely to receive adjuvant chemotherapy (51.5% vs 29.8%; P<0.0001). Older patients had a particularly poor outcome when adjuvant therapy was not delivered (median survival=13.1 months; HR 1.89, 95% CI: 1.27–2.78, P=0.002).<p></p> conclusion: Patients aged greater than or equal to70 are less likely to receive adjuvant therapy although it is associated with improved outcome. Increased use of adjuvant therapy in older individuals is encouraged as they constitute a large proportion of patients with pancreatic cancer.<p></p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Biankin, Professor Andrew and Chang, Dr David
Authors: Nagrial, A.M., Chang, D.K., Nguyen, N.Q., Johns, A.L., Chantrill, L.A., Humphris, J.L., Chin, V.T., Samra, J.S., Gill, A.J., Pajic, M., Pinese, M., Colvin, E.K., Scarlett, C.J., Chou, A., Kench, J.G., Sutherland, R.L., Horvath, L.G., and Biankin, A.V.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
Journal Name:British Journal of Cancer
Publisher:Nature Publishing Group
ISSN:0007-0920
ISSN (Online):1532-1827
Copyright Holders:Copyright © 2013 The Authors
First Published:First published in British Journal of Cancer 110(2):313-319
Publisher Policy:Reproduced under a Creative Commons License

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