Racial Disparities in Chemotherapy Response in Pancreatic Cancer: A Landmark Survival Analysis

Area of Science:

• Oncology
• Health Disparities
• Clinical Research

Background:

• Racial disparities in pancreatic adenocarcinoma (PDAC) mortality are significant.
• Differences in chemotherapy response may underlie these disparities.
• This study investigates racial differences in adjuvant chemotherapy response in PDAC.

Purpose of the Study:

• To examine racial disparities in adjuvant chemotherapy response between Black and White patients with PDAC.
• To determine if adjuvant chemotherapy provides a survival benefit for Black patients comparable to White patients.

Main Methods:

• Analysis of the National Cancer Database (2010-2019) for surgically treated PDAC patients.
• Exclusion of patients receiving neoadjuvant therapy, radiation, or with advanced stage disease (AJCC >4).
• Race-stratified survival analysis using Kaplan-Meier and Cox proportional hazards models at 6 months post-surgery.

Main Results:

• The study included 22,898 patients (89% White, 11% Black).
• Black patients were younger, more often female, and had higher comorbidity scores.
• Adjuvant chemotherapy showed a significant survival benefit in White patients (HR=0.90, P<0.01) but not in Black patients (HR=0.96, P=0.52).

Conclusions:

• Adjuvant chemotherapy is associated with improved survival exclusively in White PDAC patients.
• The lack of observed survival benefit in Black patients suggests potential underlying biological differences.
• Further research is warranted to explore these biological differences and address racial disparities in PDAC outcomes.