Clinical and molecular features of early-onset metastatic pancreatic cancer and their impact on therapeutic sequences: A multicenter study.
Year: 2025
Type: conference-abstract
Abstract: e16407 Background: Recently, there has been an increase in the incidence of early-onset PDAC (EO-PDAC), which is conventionally defined as cancer occurring in adults younger than 50 years. However, clinical and molecular data remain limited and inconsistent. Our study aimed to examine the differences in outcomes and molecular characteristics between EO-PDAC and late-onset pancreatic ductal adenocarcinoma (LO-PDAC) patients. Methods: We conducted a retrospective study involving 486 patients with metastatic pancreatic ductal adenocarcinoma across six different institutions in Italy. The study's primary objective was to evaluate the median overall survival of EO-PDAC patients compared to those with late-onset PDAC. Additionally, we aimed to assess median progression-free survival (mPFS), molecular profiles, and treatment sequences in both subgroups. Results: Of the patients, 80 (16.5%) were early onset and 406 (83.5%) were late onset. The median ages were 46 (±5) and 67 (±8) years, respectively. In the overall population, the median mOS was significantly lower in EO-PDAC patients: 10.0 versus 14.0 months ( p = 0.0103 ). Furthermore, the mPFS was also significantly lower in EO-PDAC patients: 4.0 versus 6.0 months ( p = 0.0132 ). Patients with EO-PDAC exhibited a higher prevalence of KRAS G12D and KRAS G12V mutations, at 31% and 24% respectively, compared to those with LO-PDAC. Finally, a higher percentage of LO-CRC patients continued to a second line (50.7% versus 48.6%). A percentage of 4.18% of LO-CRC patients started a fourth line, compared to 1.25% of EO-CRC. Conclusions: The results of our work showed a worse prognosis for EO-PDAC patients compared to LO-PDAC patients. This is associated with a different molecular profile and a lower percentage of patients reaching subsequent lines. Further research is necessary to better understand this expanding group of patients from molecular and therapeutic perspectives.
Source: Journal of Clinical Oncology
Authors: Andrea Pretta, Mariapaola Masiello, Chiara Carlotta Pircher, Francesco Mangogna, Letizia Procaccio, Pina Ziranu, Alessia Lancianese, Carolina Sciortino, Valentino Pasquinucci, Federico Nichetti, Stefano Mariani, Paola Andena, Clelia Donisi, Marco Puzzoni, Alessandro Bittoni, Riccardo Giampieri, Giacomo Di Paolo, Francesca Salani, Monica Niger, Mario Scartozzi
Institutions: University of Cagliari, Azienda Ospedaliero-Universitaria Cagliari, Marche Polytechnic University, Azienda Ospedaliero-Universitaria delle Marche, Fondazione IRCCS Istituto Nazionale dei Tumori, Azienda Ospedaliera Universitaria Pisana, Istituto Oncologico Veneto, University of Pisa, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, University of Padua
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4410816690