Utilization and Outcomes of Multigene Panel Testing in Patients With Pancreatic Ductal Adenocarcinoma.

Autor:	Klatte DCF; Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL.; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands., Starr JS; Division of Hematology and Oncology, Mayo Clinic, Jacksonville, FL., Clift KE; Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL., Hardway HD; Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL., van Hooft JE; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands., van Leerdam ME; Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands.; Department of Gastrointestinal Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands., Potjer TP; Department of Clinical Genetics, Leiden University Medical Center, Leiden, the Netherlands., Presutti RJ; Department of Family Medicine, Mayo Clinic, Jacksonville, FL., Riegert-Johnson DL; Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL., Wallace MB; Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL.; Department of Gastroenterology, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates., Bi Y; Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL.
Jazyk:	angličtina
Zdroj:	JCO oncology practice [JCO Oncol Pract] 2024 Aug; Vol. 20 (8), pp. 1081-1090. Date of Electronic Publication: 2024 Apr 15.
DOI:	10.1200/OP.23.00447
Abstrakt:	Purpose: Guidelines recommend germline genetic testing (GT) for patients with pancreatic ductal adenocarcinoma (PDAC). This study aims to evaluate the utilization and outcomes of multigene panel GT in patients with PDAC. Methods: This retrospective, multisite study included patients with PDAC diagnosed between May 2018 and August 2020 at Mayo Clinic Arizona, Florida, and Minnesota. Discussion, uptake, and outcomes of GT were compared before (May 1, 2018-May 1, 2019) and after (August 1, 2019-August 1, 2020) the guideline update, accounting for a transition period. Results: The study identified 533 patients with PDAC, with 321 (60.2%) preguideline and 212 (39.8%) postguideline. Patient characteristics did not differ between the preguideline and postguideline periods. GT was discussed in 34.3% (110 of 321) of preguideline and 39.6% (84 of 212) of postguideline patients (odds ratio [OR], 1.26 [95% CI, 0.88 to 1.80]) and subsequently performed in 80.9% (89 of 110) of preguideline and 75.0% (63 of 84) of postguideline patients (OR, 1.10 [95% CI, 0.75 to 1.61]). Of 152 tested patients, 26 (17.1%) had a pathogenic variant (PV), of whom 17 (11.2%; 17 of 152) were PDAC-associated. Over the entire study period, GT was more likely in younger patients (65 v 70 years; P < .001), those seen by a medical oncologist (82.9% v 69.0%; P < .001), and those surviving more than 12 months from diagnosis (70.4% v 43.4%; P < .001). Demographics and personal/family cancer history were comparable between patients with and without a PDAC PV. Conclusion: GT remains underutilized despite National Comprehensive Cancer Network guideline recommendations. Given the poor prognosis of PDAC and potential implications of GT, efforts to increase utilization are needed to provide surveillance and support to both patients with PDAC and at-risk family members.
Databáze:	MEDLINE
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