Early onset pancreatic cancer-exploring contemporary treatment and outcomes using real-world data.

Mar 07, 2024

Experts: Shehara Mendis, Lara Lipton, Yat Hang To, Sumitra Ananda, Michael Michael, Sue-Anne McLachlan, Benjamin Thomson, Benjamin Loveday, Brett Knowles, Adrian Fox, Mehrdad Nikfarjam, Val Usatoff, Julia Shapiro, Kate Clarke, Sharon Pattison, Cheng Ean Chee, Rob Zielinski, Rachel Wong, Peter Gibbs, Belinda Lee

Pancreatic cancer incidence is increasing in younger populations. Differences between early onset pancreatic cancer (EOPC) and later onset pancreatic cancer (LOPC), and how these should inform management warrant exploration in the contemporary setting.
A prospectively collected multi-site dataset on consecutive pancreatic adenocarcinoma patients was interrogated. Patient, tumour, treatment, and outcome data were extracted for EOPC (≤50 years old) vs LOPC (>50 years old).
Of 1683 patients diagnosed between 2016 and 2022, 112 (6.7%) were EOPC. EOPC more frequently had the tail of pancreas tumours, earlier stage disease, surgical resection, and trended towards increased receipt of chemotherapy in the curative setting compared to LOPC. EOPC more frequently received 1st line chemotherapy, 2nd line chemotherapy, and chemoradiotherapy than LOPC in the palliative setting. Recurrence-free survival was improved for the tail of pancreas EOPC vs LOPC in the resected setting; overall survival was superior for EOPC compared to LOPC across the resected, locally advanced unresectable and metastatic settings.
EOPC remains a small proportion of pancreatic cancer diagnoses. The more favourable outcomes in EOPC suggest these younger patients are overall deriving benefits from increased treatment in the curative setting and increased therapy in the palliative setting.

© 2024. The Author(s), under exclusive licence to Springer Nature Limited.

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ABOUT THE EXPERTS

Shehara Mendis, Lara Lipton, Yat Hang To, Sumitra Ananda, Michael Michael, Sue-Anne McLachlan, Benjamin Thomson, Benjamin Loveday, Brett Knowles, Adrian Fox, Mehrdad Nikfarjam, Val Usatoff, Julia Shapiro, Kate Clarke, Sharon Pattison, Cheng Ean Chee, Rob Zielinski, Rachel Wong, Peter Gibbs, Belinda Lee

Shehara Mendis

Walter & Eliza Hall Institute of Medical Research, Parkville, VIC, Australia. shehara.mendis@mh.org.au.

Lara Lipton

Cabrini Health, Malvern, VIC, Australia.

Yat Hang To

Walter & Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.

University of Melbourne, Parkville, VIC, Australia.

Department of Medical Oncology, Peter MacCallum Cancer Centre, Parkville, VIC, Australia.

Sumitra Ananda

University of Melbourne, Parkville, VIC, Australia.

Department of Medical Oncology, Peter MacCallum Cancer Centre, Parkville, VIC, Australia.

Michael Michael

Department of Medical Oncology, Peter MacCallum Cancer Centre, Parkville, VIC, Australia.

Sue-Anne McLachlan

University of Melbourne, Parkville, VIC, Australia.

Department of Medical Oncology, St Vincent’s Hospital, Fitzroy, VIC, Australia.

Benjamin Thomson

Department of Surgery, Royal Melbourne Hospital, Parkville, VIC, Australia.

Department of Surgical Oncology, Peter MacCallum Cancer Centre, Parkville, VIC, Australia.

Benjamin Loveday

Department of Surgery, Royal Melbourne Hospital, Parkville, VIC, Australia.

Department of Surgical Oncology, Peter MacCallum Cancer Centre, Parkville, VIC, Australia.

Brett Knowles

Department of Surgery, Royal Melbourne Hospital, Parkville, VIC, Australia.

Department of Surgical Oncology, Peter MacCallum Cancer Centre, Parkville, VIC, Australia.

Epworth Healthcare, Melbourne, VIC, Australia.

Adrian Fox

Department of Hepatobiliary Surgery, St Vincent’s Hospital, Fitzroy, VIC, Australia.

Mehrdad Nikfarjam

University of Melbourne, Parkville, VIC, Australia.

Department of Hepatobiliary Surgery, Austin Health, Heidelberg, VIC, Australia.

Val Usatoff

Cabrini Health, Malvern, VIC, Australia.

Julia Shapiro

Department of Medicine, Alfred Hospital, Prahran, VIC, Australia.

Kate Clarke

Department of Medical Oncology, Wellington Hospital, Wellington, New Zealand.

Sharon Pattison

Department of Medicine, Dunedin School of Medicine, University of Otago, Otago, New Zealand.

Cheng Ean Chee

Department of Hematology-Oncology, National University Cancer Institute, Singapore, Singapore.

Rob Zielinski

Department of Medical Oncology, Orange Hospital, Orange, NSW, Australia.

Department of Medical Oncology, Dubbo Base Hospital, Dubbo, NSW, Australia.

Department of Medical Oncology, Bathurst Base Hospital, West Bathurst, NSW, Australia.

Rachel Wong

Epworth Healthcare, Melbourne, VIC, Australia.

Eastern Health Clinical School, Monash University, Box Hill, VIC, Australia.

Department of Medical Oncology, Eastern Health, Box Hill, VIC, Australia.

Peter Gibbs

Walter & Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.

University of Melbourne, Parkville, VIC, Australia.

Belinda Lee

Walter & Eliza Hall Institute of Medical Research, Parkville, VIC, Australia.

University of Melbourne, Parkville, VIC, Australia.

Department of Medical Oncology, Peter MacCallum Cancer Centre, Parkville, VIC, Australia.

Department of Medical Oncology, Northern Hospital, Epping, VIC, Australia.