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Research Article

High Prevalence of Hereditary Cancer Syndromes and Outcomes in Adults with Early-Onset Pancreatic Cancer

Sarah A. Bannon, Maria F. Montiel, Jennifer B. Goldstein, Wenli Dong, Maureen E. Mork, Ester Borras, Merve Hasanov, Gauri R. Varadhachary, Anirban Maitra, Matthew H. Katz, Lei Feng, Andrew Futreal, David R. Fogelman, Eduardo Vilar and Florencia McAllister
Sarah A. Bannon
Clinical Cancer Genetics Program, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Maria F. Montiel
Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Jennifer B. Goldstein
Department of GI Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Wenli Dong
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Maureen E. Mork
Clinical Cancer Genetics Program, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Ester Borras
Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Merve Hasanov
Internal Medicine Department, The University of Texas Health Science Center at Houston, Houston, Texas.
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  • ORCID record for Merve Hasanov
Gauri R. Varadhachary
Department of GI Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Anirban Maitra
Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Matthew H. Katz
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Lei Feng
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Andrew Futreal
Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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David R. Fogelman
Department of GI Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Eduardo Vilar
Clinical Cancer Genetics Program, The University of Texas MD Anderson Cancer Center, Houston, Texas.Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas.Department of GI Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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Florencia McAllister
Clinical Cancer Genetics Program, The University of Texas MD Anderson Cancer Center, Houston, Texas.Department of Clinical Cancer Prevention, The University of Texas MD Anderson Cancer Center, Houston, Texas.Department of GI Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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  • For correspondence: fmcallister@mdanderson.org
DOI: 10.1158/1940-6207.CAPR-18-0014 Published November 2018
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Abstract

Introduction: We aimed to determine the prevalence and landscape of germline mutations among patients with young-onset pancreatic ductal adenocarcinoma (PDAC) as well as their influence in prognosis.

Methods: Patients from two cohorts were studied, the high-risk cohort (HRC), which included 584 PDAC patients who received genetic counseling at The University of Texas MD Anderson Cancer Center, and a general cohort (GC) with 233 metastatic PDAC patients. We defined germline DNA sequencing on 13 known pancreatic cancer susceptibility genes. The prevalence and landscape of mutations were determined, and clinical characteristics including survival were analyzed.

Results: A total of 409 patients underwent genetic testing (277 from HRC and 132 from GC). As expected, the HRC had higher prevalence of germline mutations compared with the GC: 17.3% versus 6.81%. The most common mutations in both cohorts were in BRCA1/2 and mismatch-repair (MMR) genes. Patients younger than 60 years old had significantly higher prevalence of germline mutations in both the HRC [odds ratios (OR), 1.93 ± 1.03–3.70, P = 0.039] and GC (4.78 ± 1.10–32.95, P = 0.036). Furthermore, PDAC patients with germline mutations in the GC had better overall survival than patients without mutations (HR, 0.44; 95% CI of HR, 0.25–0.76, P = 0.030).

Discussion: Germline mutations are highly prevalent in patients with PDAC of early onset and can be predictive of better outcomes. Considering emerging screening strategies for relatives carrying susceptibility genes as well as impact on therapy choices, genetic counseling and testing should be encouraged in PDAC patients, particularly those of young onset. Cancer Prev Res; 11(11); 679–86. ©2018 AACR.

Footnotes

  • Note: Supplementary data for this article are available at Cancer Prevention Research Online (http://cancerprevres.aacrjournals.org/).

  • Received January 10, 2018.
  • Revision received May 10, 2018.
  • Accepted September 24, 2018.
  • ©2018 American Association for Cancer Research.
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Cancer Prevention Research: 11 (11)
November 2018
Volume 11, Issue 11
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High Prevalence of Hereditary Cancer Syndromes and Outcomes in Adults with Early-Onset Pancreatic Cancer
Sarah A. Bannon, Maria F. Montiel, Jennifer B. Goldstein, Wenli Dong, Maureen E. Mork, Ester Borras, Merve Hasanov, Gauri R. Varadhachary, Anirban Maitra, Matthew H. Katz, Lei Feng, Andrew Futreal, David R. Fogelman, Eduardo Vilar and Florencia McAllister
Cancer Prev Res November 1 2018 (11) (11) 679-686; DOI: 10.1158/1940-6207.CAPR-18-0014

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High Prevalence of Hereditary Cancer Syndromes and Outcomes in Adults with Early-Onset Pancreatic Cancer
Sarah A. Bannon, Maria F. Montiel, Jennifer B. Goldstein, Wenli Dong, Maureen E. Mork, Ester Borras, Merve Hasanov, Gauri R. Varadhachary, Anirban Maitra, Matthew H. Katz, Lei Feng, Andrew Futreal, David R. Fogelman, Eduardo Vilar and Florencia McAllister
Cancer Prev Res November 1 2018 (11) (11) 679-686; DOI: 10.1158/1940-6207.CAPR-18-0014
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