Should Ageism Be a Stratification Factor in Patients with Pancreatic Cancer?
Abstract
With ageism being a trend worldwide, and age being a known risk factor for pancreatic cancer, the optimal management of pancreatic cancer patients with advance age is becoming more and more of a pertinent discussion amongst GI oncologists, surgical oncologists and radiation oncologists that is being increasingly addressed in studies nowadays. In an attempt to answer the question of whether age should be a cultural bias in decision making in pancreatic cancer patients, we will review Abstracts #287, #310 and #332 that were presented in the 2014 ASCO Gastrointestinal Cancers Symposium. These abstracts explore whether neoadjuvant therapy should be offered to patients older than 75 years to increase the chances of bridging to surgical resectability (Abstract #287), if patients older than age 70 years would benefit from chemotherapy similar to younger patients (Abstract #310), also whether adjuvant radiation therapy and number of lymph nodes resected in patients older than 70 years correlates with overall survival (Abstract #332).
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References
Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010. CA Cancer J Clin 2010;60:277–300.
Howlader N, Krapcho M, Neyman N, et al. SEER Cancer Statistics Review, 1975–2008. Bethesda, MD: National Cancer Institute, 2010.
Shaib YH, Davila JA, El-Serag HB. The epidemiology of pancreatic cancer in the United States: changes below the surface. Aliment Pharmacol Ther. 2006; 24:87-94.
Talarico L, Chen G, Pazdur R: Enrollment of elderly patients in clinical trials for cancer drug registration: A 7-year experience by the US Food and Drug Administration. J Clin Oncol 22:4626-4631, 2004
Bilimoria KY, Bentrem DJ, Ko CY, et al. National failure to operate on early stage pancreatic cancer. Ann Surg. 2007;246:173–180
Kleeff J, Friess H, Buchler MW. Neoadjuvant therapy for pancreatic cancer. Br J Surg. 2007;94:261–262.
Gillen S, Schuster T, Buschenfelde AM, et al. Preoperative/Neoadjuvant Therapy in Pancreatic Cancer: A Systematic Review and Meta-analysis of Response and Resection Percentages. PLoS Med. 2010 April; 7(4).
Miura JT, Krepline AN, Duelge KD, et al. Neoadjuvant therapy for pancreatic cancer in patients older than age 75. J Clin Oncol 32, 2014 (suppl 3; abstr 287)
Teo MY, Deady S, Sharp L, et al. Benefit of chemotherapy (ctx) in elderly patients (pts) with advanced pancreatic adenocarcinoma (PC): A population-based analysis. J Clin Oncol 32, 2014 (suppl 3; abstr 310)
Freilich J, Mellon EA, Springett GM, et al. Outcomes of adjuvant radiotherapy and lymph node dissection in elderly patients with pancreatic cancer treated with surgery and chemotherapy. J Clin Oncol 32, 2014 (suppl 3; abstr 332)
Oberstein PE, Hershman DL, Khanna LG, et al. Uptake and patterns of use of gemcitabine for metastatic pancreatic cancer: a population-based study. Cancer Invest. 2013; 31:316-22.
Conroy T, Desseigne F, Ychou M, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011; 364:1817-25.
Gourgou-Bourgade S, Bascoul-Mollevi C, Desseigne F, et al. Impact of FOLFIRINOX compared with gemcitabine on quality of life in patients with metastatic pancreatic cancer: results from the PRODIGE 4/ACCORD 11 randomized trial. J Clin Oncol. 2013; 31:23-9.
Cartwright T, Arlen A, Wilfong L, et al. Updated use of first-line chemotherapy for advanced pancreatic cancer: FOLFIRINOX versus gemcitabine., J Clin Oncol 31, 2013 (suppl; abstr #6607).
Conroy T, Gavoille C, Adenis A. Metastatic pancreatic cancer: old drugs, new paradigms. Curr Opin Oncol. 2011; 23:390-5.
Von Hoff DD, Ervin T, Arena FP, et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med. 2013 Oct 31;369(18):1691-703.
Hurria A, Togawa K, Mohile SG, et al. Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol. 2011; 29:3457-65.
Yancik R, Ries LA. Cancer in older persons: an international issue in an aging world. Semin Oncol. 2004 Apr;31(2):128-36.
Copyright (c) 2014 Najla H El-Jurdi, Muhammad Wasif Saif
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