TY - JOUR
T1 - The benefit of pancreatic cancer surveillance in carriers of germline BRCA1/2 pathogenic variants
AU - Laish, Ido
AU - Schechter, Menachem
AU - Dancour, Alain
AU - Lieberman, Sari
AU - Levi, Zohar
AU - Goldberg, Yael
AU - Kedar, Inbal
AU - Hasnis, Erez
AU - Half, Elizabeth
AU - Levi, Gili Reznick
AU - Katz, Lior
AU - Vainer, Elez D.
AU - Genzel, Dor
AU - Aharoni, Maya
AU - Chen-Shtoyerman, Rakefet
AU - Abu-Freha, Naim
AU - Raitses-Gurevich, Maria
AU - Golan, Talia
AU - Bernstein-Molho, Rinat
AU - Ben Yehoyada, Merav
AU - Gluck, Nathan
AU - Rosner, Guy
N1 - Publisher Copyright:
© 2023 American Cancer Society.
PY - 2024/1/15
Y1 - 2024/1/15
N2 - Background: Surveillance of high-risk individuals for pancreatic ductal adenocarcinoma (PDAC) is recommended. This study aimed to determine the prevalence and outcomes of PDAC and its precursor lesions in BRCA1/2 pathogenic variants (PVs) carriers undergoing pancreatic surveillance. Methods: A retrospective multicenter cohort study of pancreatic surveillance outcomes in Israeli BRCA1/2 carriers preferably with a family history of PDAC. Results: A total of 180 asymptomatic carriers participated in the screening programs, including 57 (31.7%) with BRCA1 PVs, 121 (67.2%) with BRCA2 PVs, and 12 (6.6%) with PVs in BRCA1/2 and other genes, for a median follow-up period of 4 years. Ninety-one individuals (50.5%) fulfilled the International Cancer of the Pancreas Screening (CAPS) criteria for surveillance whereas 116 (64.4%) fulfilled the American College of Gastroenterology (ACG) criteria. There were four cases of adenocarcinoma and four cases of grade 1-neuroendocrine tumor (G1-NET). All were BRCA2 carriers, and two had no family history of PDAC. Three cancer patients were at resectable stages (IA, IIA, IIB) whereas one had a stage IIIB tumor. Of the G1-NET cases, one had surgery and the others were only followed. Success rate for detection of confined pancreatic carcinoma was thus 1.6% (three of 180) in the whole cohort, 1.6% (two of 116) among individuals who fulfilled ACG criteria and 2.2% (two of 91) in those fulfilling CAPS criteria for surveillance. Conclusions: Despite the low detection rate of PDAC and its' high-risk neoplastic precursor lesions among BRCA1/2 carriers undergoing pancreatic surveillance, 75% of cancer cases were detected at a resectable stage.
AB - Background: Surveillance of high-risk individuals for pancreatic ductal adenocarcinoma (PDAC) is recommended. This study aimed to determine the prevalence and outcomes of PDAC and its precursor lesions in BRCA1/2 pathogenic variants (PVs) carriers undergoing pancreatic surveillance. Methods: A retrospective multicenter cohort study of pancreatic surveillance outcomes in Israeli BRCA1/2 carriers preferably with a family history of PDAC. Results: A total of 180 asymptomatic carriers participated in the screening programs, including 57 (31.7%) with BRCA1 PVs, 121 (67.2%) with BRCA2 PVs, and 12 (6.6%) with PVs in BRCA1/2 and other genes, for a median follow-up period of 4 years. Ninety-one individuals (50.5%) fulfilled the International Cancer of the Pancreas Screening (CAPS) criteria for surveillance whereas 116 (64.4%) fulfilled the American College of Gastroenterology (ACG) criteria. There were four cases of adenocarcinoma and four cases of grade 1-neuroendocrine tumor (G1-NET). All were BRCA2 carriers, and two had no family history of PDAC. Three cancer patients were at resectable stages (IA, IIA, IIB) whereas one had a stage IIIB tumor. Of the G1-NET cases, one had surgery and the others were only followed. Success rate for detection of confined pancreatic carcinoma was thus 1.6% (three of 180) in the whole cohort, 1.6% (two of 116) among individuals who fulfilled ACG criteria and 2.2% (two of 91) in those fulfilling CAPS criteria for surveillance. Conclusions: Despite the low detection rate of PDAC and its' high-risk neoplastic precursor lesions among BRCA1/2 carriers undergoing pancreatic surveillance, 75% of cancer cases were detected at a resectable stage.
KW - BRCA carrier
KW - pancreatic cancer
KW - surveillance
UR - http://www.scopus.com/inward/record.url?scp=85174421846&partnerID=8YFLogxK
U2 - 10.1002/cncr.35052
DO - 10.1002/cncr.35052
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
AN - SCOPUS:85174421846
SN - 0008-543X
VL - 130
SP - 256
EP - 266
JO - Cancer
JF - Cancer
IS - 2
ER -