Impact of concurrent medications use on outcome of pancreatic cancer: SEER Medicare analysis.

Authors

Shaalan Beg

Muhammad Shaalan Beg

Division of Hematology/Oncology, The University of Texas Southwestern Medical Center, Dallas, TX

Muhammad Shaalan Beg , Tyler Stewart , Ang Gao , Chul Ahn , Jarett Berry , Eric Mortensen

Organizations

Division of Hematology/Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, The Univeristy of Texas Southwestern Medical Center, Dallas, TX, The University of Texas Southwestern Medical Center, Dallas, TX

Research Funding

No funding sources reported

Background: Preclinical studies have suggested concurrent non-antineoplastic medication use may impact pancreatic cancer. We performed an analysis to examine these associations on survival in pancreatic cancer. Methods: Data from the Surveillance, Epidemiology and End Results (SEER)-Medicare with available part D data between 2006 and 2009 were analyzed. Cases with non-adenocarcinoma histology, autopsy only and death certificate only data were excluded. Drug use was defined as having two prescriptions filled within 12 months of pancreatic cancer diagnosis. The following medications were analyzed: beta-blocker, statin, insulin, metformin, thiazolidinedione, warfarin and heparin. The primary end point was overall survival. Stepwise Cox proportional hazard models were employed including each medication group as well as age, gender, stage, site, grade, diabetes, race and Charlson comorbidity score. Results: There were 13,702 cases which met inclusion criteria and had available Part D data. Median age was 76 years, There were 42.5% males, 77.1% were white and 34.0%had diabetes. Head of the pancreas tumors accounted for 49.9% cases and 49.6% had stage 4 disease and at diagnosis. The results of the stepwise Cox proportional hazard models are summarized in table 1. Beta blockers, heparin, insulin, warfarin were associated were significantly with improved survival (p<0.05). Conclusions: Concurrent medication use, particularly heparin, insulin warfarin and beta-blockers are associated with improved survival in patients with pancreatic cancer. Diabetes medications (metformin, TZD) did not have an impact in the multivariable model. Additional studies are needed to examine whether these medications may improve outcomes for patients with pancreatic cancer.

MedicationHR (CI)
Beta blocker0.92 (0.88, 0.96)
Insulin0.89 (0.84, 0.93)
Warfarin0.90 (0.84, 0.95)
Heparin0.76 (0.70, 0.82)
Age1.03 (1.03, 1.04)
Race (other vs. white)1.07 (1.03, 1.12)
Stage (3/4 vs. 1/2)2.48 (2.37, 2.59)
Charlson score (1+ vs. 0)1.42 (1.24, 1.62)
Site (251+ vs. 250)1.09 (1.04, 1.13)

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Abstract Details

Meeting

2016 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Cancers of the Pancreas, Small Bowel, and Hepatobiliary Tract

Track

Cancers of the Pancreas, Small Bowel, and Hepatobiliary Tract

Sub Track

Multidisciplinary Treatment

Citation

J Clin Oncol 34, 2016 (suppl 4S; abstr 378)

DOI

10.1200/jco.2016.34.4_suppl.378

Abstract #

378

Poster Bd #

J14

Abstract Disclosures

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