Racial and gender disparities in next-generation sequencing for pancreatic adenocarcinoma

Document Type

Conference Proceeding

Publication Date


Publication Title

Cancer Epidemiol Biomarkers Prev


Introduction: Racial and gender disparities have been described in many aspects of cancer care including genome sequencing. Next-generation sequencing (NGS) has become a widely available tool for genome sequencing and led to advances in the treatment of many malignancies such as lung cancer. However, its role in pancreatic adenocarcinoma is limited partly due to the lack of complete understanding of the genomic landscape of the disease. The goal of our study is to evaluate racial and gender disparities in NGS of primary (PPDA) and metastatic (MPDA) pancreatic adenocarcinoma and its effect on patient outcomes. Methods: Clinical and genomic data were received for 150 patients, 75 PPDA and 75 MPDA, from Tempus. The 50 patients with no race information were excluded from this study. DNA sequencing of 648 genes was performed using the Tempus xT and xO assays. Patients were divided based on gender (male and female), race (white and non-white including African American and Asian), and disease status (PPDA and MPDA). The racial and gender representation as well as the frequency of somatic mutations were compared between groups. Kaplan Meier curves were created for the progression free survival (PFS; time from first diagnosis to first progression event or death) of each group. Results: A sample of 100 unique patients was analyzed. Almost half of them were males (49%) and around 90% were white. In the PPDA cohort (N=55), 56.4% were males and 83.6% were white. On the other hand, 60% of MPDA patients (N=45) were females and 95.6% were white. The most frequently mutated genes were KRAS (91.9%), TP53 (73.7%), CDKN2A (48.5%), SMAD4 (33.3%), ATM (14.1%). Comparing the rates of these mutations between groups, females had a Skip to main content higher mutation rate in the 5 top mutated genes. White patients had a higher mutation rate in KRAS, TP53 (77.3% [n=68] vs 45.5% [n=7], p 0.034) and SMAD4; whereas non-white patients had a higher mutation rate in CDKN2A and ATM. Of the 100 patients, 80 patients progressed, and 44 patients died. The death rate was 44.9% (22/49) for males and 43.1% (22/51) for females. The death rate for white and non-white patients was 41.6% (37/89) and 63.6% (7/11), respectively. The median PFS (mPFS) was 17.3 months for males and 21.3 months for females. The mPFS for white and non-white was 18.7 and 18 months, respectively. In the PPDA cohort, the mPFS was 16.1 months for males and 14.6 months for females. The mPFS for white and non-white patients was 14.9 and 16.1 months, respectively. In the MPDA cohort, the mPFS was 25.4 months for males and 21.1 months for females. The mPFS for white and non-white patients was 22.7 and 26.1 months, respectively. Conclusion: Racial disparity was detected in NGS for PDA with 90% of the population studied being of white ethnicity indicating an over-representation of white patients among the cases profiled by Tempus. TP53 was more frequently detected in white patients as compared to non-white. Progression survival difference was detected among groups but was not statistically significant.

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Not assigned.