title: Impact of Concurrent Medication Use on Pancreatic Cancer Survival-SEER-Medicare Analysis.
abstract: Preclinical studies have suggested that non-antineoplastic medication use may impact pancreatic cancer biology. We examined the association of several medication classes on pancreatic cancer survival in a large medical claims database.
  
  
  
  Histologically confirmed pancreatic adenocarcinoma diagnosed between 2006 and 2009 were analyzed from the Surveillance, Epidemiology, and End Results-Medicare database with available part D data. Drug use was defined as having 2 prescriptions filled within 12 months of pancreatic cancer diagnosis. The following medication classes/combinations were analyzed: β-blocker, statin, insulin, metformin, thiazolidinedione, warfarin, heparin, β-blocker/statin, metformin/statin, and β-blocker/metformin. Multivariable Cox proportional hazard models adjusting for age, sex, race, stage at diagnosis, site of cancer, and Charlson comorbidity index were constructed to test the association between medication classes and overall survival.
  
  
  
  A total of 13,702 patients were included in the study; median age 76 years, 42.5% males, 77.1% white. The most common anatomic site and stage at diagnosis were head of the pancreas (49.9%) and stage 4 (49.6%), respectively. Ninety-four percent of patients died in the follow-up period (median overall survival 5.3 mo). Multivariable Cox regression analysis showed that use of β-blockers, heparin, insulin, and warfarin were significantly associated with improved survival (P<0.05 for each one), whereas metformin, thiazolidinedione, statin, and combination therapies were not.
  
  
  
  In this study, use of β-blockers, heparin, insulin, and warfarin were associated with improved survival in patients with pancreatic cancer. Additional studies are needed to validate these findings in the clinical setting.
authors.affiliation: Divisions of Hematology/Oncology.|Harold C. Simmons Cancer Center.
authors.forename: Muhammad S
authors.initials: MS
authors.lastname: Beg
authors.affiliation: Departments of Internal Medicine.
authors.forename: Arjun
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Harold C. Simmons Cancer Center.|Radiation Oncology.
authors.forename: David
authors.initials: D
authors.lastname: Sher
authors.affiliation: Endocrinology and Metabolism.
authors.forename: Sadia
authors.initials: S
authors.lastname: Ali
authors.affiliation: Divisions of Hematology/Oncology.|Harold C. Simmons Cancer Center.
authors.forename: Saad
authors.initials: S
authors.lastname: Khan
authors.affiliation: Clinical Sciences, University of Texas-Southwestern Medical Center.
authors.forename: Ang
authors.initials: A
authors.lastname: Gao
authors.affiliation: Departments of Internal Medicine.
authors.forename: Tyler
authors.initials: T
authors.lastname: Stewart
authors.affiliation: Harold C. Simmons Cancer Center.|Clinical Sciences, University of Texas-Southwestern Medical Center.
authors.forename: Chul
authors.initials: C
authors.lastname: Ahn
authors.affiliation: Cardiology.
authors.forename: Jarett
authors.initials: J
authors.lastname: Berry
authors.affiliation: Departments of Internal Medicine.|Clinical Sciences, University of Texas-Southwestern Medical Center.|VA North Texas Health Care System, Dallas, TX.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Mortensen
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D006278:Medicare; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality*; D055553:Prescription Drugs / Q000627:therapeutic use*; D018426:SEER Program; D014481:United States
chemical_list: D055553:Prescription Drugs