Does race affect the long-term survival benefit of systemic therapy in pancreatic adenocarcinoma?

• Published in: The American journal of surgery Vol. 224; no. 3; pp. 955 - 958
• Main Authors: Irfan, Ahmer, Fang, Hua A., Awad, Seifeldin, Alkashah, Ahmad, Vickers, Selwyn M., Gbolahan, Olumide, Williams, Grant R., Nien-Tsu Wang, Thomas, Dudeja, Vikas, Rose, J. Bart, Reddy, Sushanth
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2022; Elsevier Limited
• Subjects: Adenocarcinoma; Adjuvant therapy; Cancer therapies; Carcinoma, Pancreatic Ductal; Chemotherapy; Disparities in care; Humans; Inequality; Lymphatic system; Mortality; Pancreas; Pancreatic adenocarcinoma; Pancreatic cancer; Pancreatic Neoplasms; Patients; Race; Race factors; Racial differences; Retrospective Studies; Social factors; Statistical analysis; Survival; Survival analysis; Therapy; Tumors; Variance analysis; United States > US; Pancreatic adenocarcinoma; PDAC; Adjuvant therapy; UAB; Disparities in care
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2022.04.004

Systemic therapy is a key management component of pancreatic ductal adenocarcinoma(PDAC). Racial disparities exist in PDAC, often linked to socioeconomic variables. We investigated the impact of race in PDAC patients who had undergone systemic therapy and surgical resection.
A retrospective analysis was performed for all patients who underwent surgical resection for PDAC from 2010 to 2018.
234 patients (78.2% White; 21.8% Black) were included. Black patients presented at a younger age with larger tumors. White patients benefited from systemic therapy with longer overall survival (35vs20 months, p = 0.002). This survival advantage was not present in Black patients (21vs15 months, p = 0.15). Black patients receiving systemic therapy had similar survival as White patients who did not (p = 0.81).
Black PDAC patients present at younger ages and with larger initial tumors. In our population, White patients had a longer overall survival after both surgical and systemic therapy. These findings may indicate differences in tumor biology. Further prospective studies are needed.
•Pancreatic Cancer is increasingly viewed as a systemic disease, with chemotherapy a key component of treatment.•Known racial disparities exist in the outcomes from pancreatic cancer, often linked to socioeconomic variables.•In patients undergoing surgery and systemic therapy, White patients were found to have improved survival compared to Black.•Differences in tumour biology may account for these differences, but controlled prospective studies are needed.