TY - JOUR
T1 - Sex, Gender and Age Differences in Treatment Allocation and Survival of Patients With Metastatic Pancreatic Cancer
T2 - A Nationwide Study
AU - Pijnappel, Esther N.
AU - Schuurman, Melinda
AU - Wagner, Anna D.
AU - de Vos-Geelen, Judith
AU - Geest, Lydia G. M. van der
AU - de Groot, Jan-Willem B.
AU - Koerkamp, Bas Groot
AU - de Hingh, Ignace H. J. T.
AU - Homs, Marjolein Y. V.
AU - Creemers, Geert-Jan
AU - Cirkel, Geert A.
AU - van Santvoort, Hjalmar C.
AU - Dutch Pancreatic Cancer Group
AU - Busch, Olivier R.
AU - Besselink, Marc G.
AU - van Eijck, Casper H. J.
AU - Wilmink, Johanna W.
AU - van Laarhoven, Hanneke W. M.
N1 - Funding Information: 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. Funding Information: The authors thank the registration team of the Netherlands Comprehensive Cancer Organization (IKNL) for the collection of data for the Netherlands Cancer Registry. The abstract of this study was presented at the European Society for Medical Oncology (ESMO) virtual congress 2021. Publisher 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.
PY - 2022/3/24
Y1 - 2022/3/24
N2 - 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.
AB - 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.
KW - drug therapy
KW - gender identity
KW - palliative treatment
KW - pancreatic cancer
KW - pancreatic neoplasms
KW - sex
KW - systemic treatment
UR - http://www.scopus.com/inward/record.url?scp=85130829955&partnerID=8YFLogxK
U2 - https://doi.org/10.3389/fonc.2022.839779
DO - https://doi.org/10.3389/fonc.2022.839779
M3 - Article
C2 - 35402271
SN - 2234-943X
VL - 12
JO - Frontiers in Oncology
JF - Frontiers in Oncology
M1 - 839779
ER -