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Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting

BACKGROUND: Genetic testing is recommended for all pancreatic ductal adenocarcinoma (PDAC) patients. Prior research demonstrates that multidisciplinary pancreatic cancer clinics (MDPCs) improve treatment‐ and survival‐related outcomes for PDAC patients. However, limited information exists regarding...

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Autores principales: Everett, Jessica N., Dettwyler, Shenin A., Jing, Xiaohong, Stender, Cody, Schmitter, Madeleine, Baptiste, Ariele, Chun, Jennifer, Kawaler, Emily A., Khanna, Lauren G., Gross, Seth A., Gonda, Tamas A., Beri, Nina, Oberstein, Paul E., Simeone, Diane M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9939217/
https://www.ncbi.nlm.nih.gov/pubmed/35906821
http://dx.doi.org/10.1002/cam4.5059
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author Everett, Jessica N.
Dettwyler, Shenin A.
Jing, Xiaohong
Stender, Cody
Schmitter, Madeleine
Baptiste, Ariele
Chun, Jennifer
Kawaler, Emily A.
Khanna, Lauren G.
Gross, Seth A.
Gonda, Tamas A.
Beri, Nina
Oberstein, Paul E.
Simeone, Diane M.
author_facet Everett, Jessica N.
Dettwyler, Shenin A.
Jing, Xiaohong
Stender, Cody
Schmitter, Madeleine
Baptiste, Ariele
Chun, Jennifer
Kawaler, Emily A.
Khanna, Lauren G.
Gross, Seth A.
Gonda, Tamas A.
Beri, Nina
Oberstein, Paul E.
Simeone, Diane M.
author_sort Everett, Jessica N.
collection PubMed
description BACKGROUND: Genetic testing is recommended for all pancreatic ductal adenocarcinoma (PDAC) patients. Prior research demonstrates that multidisciplinary pancreatic cancer clinics (MDPCs) improve treatment‐ and survival‐related outcomes for PDAC patients. However, limited information exists regarding the utility of integrated genetics in the MDPC setting. We hypothesized that incorporating genetics in an MDPC serving both PDAC patients and high‐risk individuals (HRI) could: (1) improve compliance with guideline‐based genetic testing for PDAC patients, and (2) optimize HRI identification and PDAC surveillance participation to improve early detection and survival. METHODS: Demographics, genetic testing results, and pedigrees were reviewed for PDAC patients and HRI at one institution over 45 months. Genetic testing analyzed 16 PDAC‐associated genes at minimum. RESULTS: Overall, 969 MDPC subjects were evaluated during the study period; another 56 PDAC patients were seen outside the MDPC. Among 425 MDPC PDAC patients, 333 (78.4%) completed genetic testing; 29 (8.7%) carried a PDAC‐related pathogenic germline variant (PGV). Additionally, 32 (9.6%) met familial pancreatic cancer (FPC) criteria. These PDAC patients had 191 relatives eligible for surveillance or genetic testing. Only 2/56 (3.6%) non‐MDPC PDAC patients completed genetic testing (p < 0.01). Among 544 HRI, 253 (46.5%) had a known PGV or a designation of FPC, and were eligible for surveillance at baseline; of the remainder, 15/291 (5.2%) were eligible following genetic testing and PGV identification. CONCLUSION: Integrating genetics into the multidisciplinary setting significantly improved genetic testing compliance by reducing logistical barriers for PDAC patients, and clarified cancer risks for their relatives while conserving clinical resources. Overall, we identified 206 individuals newly eligible for surveillance or genetic testing (191 relatives of MDPC PDAC patients, and 15 HRI from this cohort), enabling continuity of care for PDAC patients and at‐risk relatives in one clinic.
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spelling pubmed-99392172023-02-20 Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting Everett, Jessica N. Dettwyler, Shenin A. Jing, Xiaohong Stender, Cody Schmitter, Madeleine Baptiste, Ariele Chun, Jennifer Kawaler, Emily A. Khanna, Lauren G. Gross, Seth A. Gonda, Tamas A. Beri, Nina Oberstein, Paul E. Simeone, Diane M. Cancer Med RESEARCH ARTICLES BACKGROUND: Genetic testing is recommended for all pancreatic ductal adenocarcinoma (PDAC) patients. Prior research demonstrates that multidisciplinary pancreatic cancer clinics (MDPCs) improve treatment‐ and survival‐related outcomes for PDAC patients. However, limited information exists regarding the utility of integrated genetics in the MDPC setting. We hypothesized that incorporating genetics in an MDPC serving both PDAC patients and high‐risk individuals (HRI) could: (1) improve compliance with guideline‐based genetic testing for PDAC patients, and (2) optimize HRI identification and PDAC surveillance participation to improve early detection and survival. METHODS: Demographics, genetic testing results, and pedigrees were reviewed for PDAC patients and HRI at one institution over 45 months. Genetic testing analyzed 16 PDAC‐associated genes at minimum. RESULTS: Overall, 969 MDPC subjects were evaluated during the study period; another 56 PDAC patients were seen outside the MDPC. Among 425 MDPC PDAC patients, 333 (78.4%) completed genetic testing; 29 (8.7%) carried a PDAC‐related pathogenic germline variant (PGV). Additionally, 32 (9.6%) met familial pancreatic cancer (FPC) criteria. These PDAC patients had 191 relatives eligible for surveillance or genetic testing. Only 2/56 (3.6%) non‐MDPC PDAC patients completed genetic testing (p < 0.01). Among 544 HRI, 253 (46.5%) had a known PGV or a designation of FPC, and were eligible for surveillance at baseline; of the remainder, 15/291 (5.2%) were eligible following genetic testing and PGV identification. CONCLUSION: Integrating genetics into the multidisciplinary setting significantly improved genetic testing compliance by reducing logistical barriers for PDAC patients, and clarified cancer risks for their relatives while conserving clinical resources. Overall, we identified 206 individuals newly eligible for surveillance or genetic testing (191 relatives of MDPC PDAC patients, and 15 HRI from this cohort), enabling continuity of care for PDAC patients and at‐risk relatives in one clinic. John Wiley and Sons Inc. 2022-07-30 /pmc/articles/PMC9939217/ /pubmed/35906821 http://dx.doi.org/10.1002/cam4.5059 Text en © 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle RESEARCH ARTICLES
Everett, Jessica N.
Dettwyler, Shenin A.
Jing, Xiaohong
Stender, Cody
Schmitter, Madeleine
Baptiste, Ariele
Chun, Jennifer
Kawaler, Emily A.
Khanna, Lauren G.
Gross, Seth A.
Gonda, Tamas A.
Beri, Nina
Oberstein, Paul E.
Simeone, Diane M.
Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting
title Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting
title_full Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting
title_fullStr Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting
title_full_unstemmed Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting
title_short Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting
title_sort impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting
topic RESEARCH ARTICLES
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9939217/
https://www.ncbi.nlm.nih.gov/pubmed/35906821
http://dx.doi.org/10.1002/cam4.5059
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