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. 2023 Jan;12(1):200-212.
doi: 10.1002/cam4.4903. Epub 2022 Jun 8.

Survival of cancer survivors with a new pancreatic cancer diagnosis

Sandi L Pruitt  1   2 , Anna Tavakkoli  1   2   3 , Hong Zhu  1   2 , Daniel F Heitjan  1   4 , David E Gerber  1   2   3 , Amit G Singal  1   2   3 , Ethan A Halm  5   6 , Muhammad Shaalan Beg  2 , Bhumika Maddineni  1 , Ankit J Kansagra  2   3 , Caitlin C Murphy  7
Affiliations

Survival of cancer survivors with a new pancreatic cancer diagnosis

Sandi L Pruitt et al. Cancer Med. 2023 Jan.

Abstract

Background: Persons newly diagnosed with pancreas cancer and who have survived a previous cancer are often excluded from clinical trials, despite limited evidence about their prognosis. We examined the association between previous cancer and overall survival.

Methods: This US population-based cohort study included older adults (aged ≥66 years) diagnosed with pancreas cancer between 2005 and 2015 in the linked Surveillance, Epidemiology, and End Results-Medicare data. We used Cox proportional hazards models to estimate stage-specific effects of previous cancer on overall survival, adjusting for sociodemographic, treatment, and tumor characteristics.

Results: Of 32,783 patients, 18.7% were previously diagnosed with another cancer. The most common previous cancers included prostate (29.0%), breast (18.9%), or colorectal (9.7%) cancer. More than half of previous cancers (53.9%) were diagnosed 5 or more years prior to pancreas cancer diagnosis or at an in situ or localized stage (47.8%). The proportions of patients surviving 1, 3, and 5 years after pancreas cancer were nearly identical for those with and without previous cancer. Median survival in months was as follows for those with and without previous cancer respectively: 7 versus 8 (Stage 0/I), 10 versus 10 (Stage II), 7 versus 7 (Stage III), and 3 versus 2 (Stage IV). Cox models indicated that patients with previous cancer had very similar or statistically equivalent survival to those with no previous cancer.

Conclusions: Given nearly equivalent survival compared to those without previous cancer, cancer survivors newly diagnosed with pancreas cancer should be considered for inclusion in pancreas cancer clinical trials.

Keywords: clinical trials; multiple malignancies; pancreas cancer; survival.

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Conflict of interest statement

Daniel F. Heitjan reports consulting (Bluejay Diagnostics, Braintree labs, Creatics LLC, Abbott Labs, Macrogenics, Inc.,) and legal consulting (Noven, Pfizer, Women's Talc Project); Caitlin C. Murphy reports consulting (Freenome); Amit G. Singal reports consulting/advisory boards (Bayer, Eisai, Genentech, BMS, Exelixis, Exact Sciences, GRAIL); David E. Gerber reports research funding (Astra‐Zeneca, BerGenBio, Karyopharm), stock ownership (Gilead) and consulting (Samsung Bioepis, Jansen, Catalyst Pharmaceuticals). Ankit J. Kansagra reports advisory board (Alynylam, BMS/Celgene, Cota Health, GSK, Janssen, Oncopeptide).

Figures

FIGURE 1
FIGURE 1
Overall survival curves for pancreas cancer patients with and without previous cancer, by pancreas cancer stage.
FIGURE 2
FIGURE 2
Impact of previous cancer on overall survival among patients with pancreas cancer for the overall population and clinical trial subset surviving ≥30 days after pancreas cancer diagnosis, by pancreas cancer stage.
See this image and copyright information in PMC

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