title: Uptake and patterns of use of gemcitabine for metastatic pancreatic cancer: a population-based study.
abstract: Gemcitabine was approved for advanced pancreatic cancer in 1996. We investigated uptake and predictors of its use. We identified 3,231 individuals > 65 years in the SEER-Medicare database with stage IV pancreatic adenocarcinoma, diagnosed between 1998-2005, who survived > 30 days. Of these, 54% received chemotherapy, 93% with gemcitabine. Gemcitabine nonreceipt was associated with advanced age and unmarried (OR: 0.65, 95% CI: 0.55-0.76). Diagnosis in 2004-2005 versus 1998-2000 was more likely to receive gemcitabine (OR: 1.51, 95% CI: 1.23-1.84) as were higher SES patients (highest versus lowest quintile, OR: 2.14, 95% CI: 1.60-2.85). Gemcitabine was rapidly adopted among elderly advanced pancreatic cancer patients; several factors are associated with use.
authors.affiliation: Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Oberstein
authors.forename: Dawn L
authors.initials: DL
authors.lastname: Hershman
authors.forename: Lauren G
authors.initials: LG
authors.lastname: Khanna
authors.forename: John A
authors.initials: JA
authors.lastname: Chabot
authors.forename: Beverly J
authors.initials: BJ
authors.lastname: Insel
authors.forename: Alfred I
authors.initials: AI
authors.lastname: Neugut
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D015331:Cohort Studies; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D006278:Medicare; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D018426:SEER Program; D014481:United States; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine