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Showing content from https://www.ncbi.nlm.nih.gov/pubmed/30883245 below:

Deleterious Germline Mutations Are a Risk Factor for Neoplastic Progression Among High-Risk Individuals Undergoing Pancreatic Surveillance

. 2019 May 1;37(13):1070-1080. doi: 10.1200/JCO.18.01512. Epub 2019 Mar 18. Deleterious Germline Mutations Are a Risk Factor for Neoplastic Progression Among High-Risk Individuals Undergoing Pancreatic Surveillance Amanda L Blackford¹, Koji Tamura¹, Madeline Ford¹, Patrick McCormick¹, Miguel Chuidian¹, Jose Alejandro Almario¹, Michael Borges¹, Anne Marie Lennon¹, Eun Ji Shin¹, Alison P Klein¹, Ralph H Hruban¹, Marcia I Canto¹, Michael Goggins¹

Affiliations

Affiliation

¹ 1 Johns Hopkins Medical Institutions, Baltimore, MD.

PMID: 30883245
PMCID: PMC6494358
DOI: 10.1200/JCO.18.01512

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Deleterious Germline Mutations Are a Risk Factor for Neoplastic Progression Among High-Risk Individuals Undergoing Pancreatic Surveillance

Toshiya Abe et al. J Clin Oncol. 2019.

. 2019 May 1;37(13):1070-1080. doi: 10.1200/JCO.18.01512. Epub 2019 Mar 18. Authors Toshiya Abe¹, Amanda L Blackford¹, Koji Tamura¹, Madeline Ford¹, Patrick McCormick¹, Miguel Chuidian¹, Jose Alejandro Almario¹, Michael Borges¹, Anne Marie Lennon¹, Eun Ji Shin¹, Alison P Klein¹, Ralph H Hruban¹, Marcia I Canto¹, Michael Goggins¹ Affiliation

¹ 1 Johns Hopkins Medical Institutions, Baltimore, MD.

PMID: 30883245
PMCID: PMC6494358
DOI: 10.1200/JCO.18.01512

Item in Clipboard

Abstract

Purpose: To compare the risk of neoplastic progression by germline mutation status versus family history without a known germline mutation (familial risk) among individuals with an increased risk for pancreatic cancer who are undergoing surveillance.

Methods: Of 464 high-risk individuals in the Cancer of the Pancreas Screening program at Johns Hopkins Hospital who were undergoing pancreatic surveillance, 119 had a known deleterious germline mutation in a pancreatic cancer susceptibility gene; 345 met family history criteria for pancreatic surveillance but were not known to harbor a germline mutation. We used next-generation sequencing to identify previously unrecognized germline mutations among these 345 individuals. We compared the development of pancreatic cancer, high-grade dysplasia, or clinically worrisome features, adjusting for competing mortality, among all germline mutation carriers with the risk of progression in a cohort without a known germline mutation.

Results: Fifteen (4.3%) of 345 individuals classified as having familial risk had a previously unrecognized pancreatic cancer susceptibility gene mutation (nine that involved ATM, two BRCA2, one BRCA1, one PALB2, one TP53, and one CPA1). The cumulative incidence of pancreatic cancer, high-grade dysplasia, or worrisome features on pancreatic imaging was significantly higher in the germline mutation risk group (n = 134) than in the familial risk group (n = 330 [for pancreatic cancer, hazard ratio, 2.85; 95% CI, 1.0 to 8.18; P = .05]).

Conclusion: The cumulative incidence of pancreatic cancer is significantly higher among individuals with an identifiable deleterious germline mutation in a pancreatic cancer susceptibility gene than it is among individuals with a strong family history but no identified mutation. Gene testing of individuals who meet criteria for pancreatic surveillance on the basis of their family history may better define those most at risk for neoplastic progression.

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Figures
FIG 1.

Estimates of time to pancreatic…

FIG 1.

Estimates of time to pancreatic cancer diagnosis according to germline mutation status. CAPS,…

FIG 1.

Estimates of time to pancreatic cancer diagnosis according to germline mutation status. CAPS, Cancer of the Pancreas Screening; HR, hazard ratio; PDAC, pancreatic ductal adenocarcinoma.