Prevalence of Germline Mutations in Cancer Predisposition Genes in Patients with Pancreatic Cancer or Suspected Related Hereditary Syndromes: Historical Prospective Analysis

被引:8
作者
Dal Buono, Arianna [1 ]
Poliani, Laura [2 ,3 ]
Greco, Luana [4 ]
Bianchi, Paolo [5 ]
Barile, Monica [1 ]
Giatti, Valentina [1 ]
Bonifacio, Cristiana [6 ]
Carrara, Silvia [1 ]
Malesci, Alberto [2 ,3 ]
Laghi, Luigi [4 ,7 ]
机构
[1] IRCCS Humanitas Res Hosp, Dept Gastroenterol, I-20089 Milan, Italy
[2] IRCCS Osped San Raffaele, Gastroenterol & Endoscopy, I-20132 Milan, Italy
[3] Univ Vita Salute San Raffaele, I-20132 Milan, Italy
[4] IRCCS Humanitas Res Hosp, Dept Gastroenterol, Lab Mol Gastroenterol, I-20089 Milan, Italy
[5] IRCCS Humanitas Res Hosp, Med Anal Lab, I-20089 Milan, Italy
[6] IRCCS Humanitas Res Hosp, Radiol Dept, I-20089 Milan, Italy
[7] Univ Parma, Dept Med & Surg, I-43125 Parma, Italy
关键词
pancreatic cancer; hereditary syndrome; pathogenic variant; germline mutation; cancer predisposition; HIGH-RISK INDIVIDUALS; VARIANTS;
D O I
10.3390/cancers15061852
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Simple Summary Approximately 5-10% of all pancreatic adenocarcinomas (PDACs) are caused by highly penetrant pathogenic germline variants (PVs). Specific surveillance programs and eventual targeted oncological therapies can be offered to patients carrying some of the known PVs. We prospectively investigated the prevalence of germline PVs in cancer-predisposing genes in patients referred for genetic evaluation at our institution. In our cohort, 20.1% of the tested subjects harbored at least one PV in the genes of interest. Since the mutational burden in patients affected by PDAC or referred for a suspected related hereditary syndrome is high, the incorporation of genetic testing and the adoption of multiple-gene panels within the multidisciplinary management of this disease would be beneficial and desirable.We investigate the prevalence of germline mutations in cancer predisposition genes in patients with pancreatic ductal adenocarcinoma (PDAC) or suspected related hereditary syndromes. Methods: we enrolled for NGS with an Illumina TrueSight Cancer panel comprising 19 CPGs and 113 consecutive subjects referred to cancer genetic clinics for metastatic PDAC, early onset PDAC, suspected hereditary syndrome, or positive family history. Results: Overall, 23 (20.1%) subjects were carriers of 24 pathogenetic variants (PVs). We found 9 variants in BRCA2 (37.5%), 6 in CDKN2A (25%), 3 in ATM (12.5%), 2 in BRCA1 (8.3%), 1 in CHEK2 (4.1%), 1 in PALB2 (4.1%), 1 in MITF (4.1%), and 1 in FANCM (4.1%). A double PV (BRCA1 plus BRCA2) was found in 1 subject. We observed a nearly 30% (16/55) mutational rate in the subgroup of subjects tested for the suspected syndromes (PDAC and other synchronous or metachronous tumors or an indicative family history), and the frequency was significantly higher than that in patients with only metastatic PDAC (p = 0.05). In our cohort, 39 variants of unknown significance (VUS) were identified, most of which (16/39, 41%) in genes belonging to the Lynch syndrome spectrum. Conclusion: A clinically relevant proportion of pancreatic cancer is associated with mutations in known predisposition genes. Guidelines instructing on an adequate selection for accessing genetic testing are eagerly needed. The heterogeneity of mutations identified in this study reinforces the value of using a multiple-gene panel in pancreatic cancer.
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页数:10
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