Subclassification Can Tailor Surveillance for Pancreatic Adenocarcinoma

High-risk individuals were classified into three groups based on familial pancreatic cancer and a pathogenic germline variant
Subclassification Can Tailor Surveillance for Pancreatic Adenocarcinoma
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Medically Reviewed By:
Mark Arredondo, M.D.

WEDNESDAY, April 17, 2024 (HealthDay News) -- Subclassification of individuals at high risk for pancreatic adenocarcinoma (PC) can enable the development of surveillance approaches better tailored to risk, according to a study published online April 16 in the Journal of the National Comprehensive Cancer Network.

George Zogopoulos, M.D., Ph.D., from McGill University Health Center in Montreal, and colleagues established a multi-institutional international collaboration, the Pancreatic Cancer Early Detection (PRECEDE) Consortium, to address the unmet clinical need for surveillance for high-risk individuals (HRIs). A total of 3,402 participants were enrolled in one of seven study cohorts from April 1, 2020, to Nov. 21, 2022; 51.7 percent met the criteria for the highest-risk cohort (cohort 1). Cohort 1 HRIs underwent germline testing and pancreas imaging.

A total of 1,400 participants in cohort 1 had completed baseline imaging and were classified into three groups based on familial PC (FPC; 670 participants); a pathogenic germline variant (PGV) and FPC (PGV+/FPC+; 115 participants); and a PGV with a pedigree that did not meet the criteria for FPC (PGV+/FPC−; 615 participants). The researchers found that on study entry, one HRI was diagnosed with stage IIB PC; 35.1 percent of HRIs harbored pancreatic cysts. Independent predictors of harboring a pancreatic cyst included older age (odds ratio, 1.05) and FPC group assignment (odds ratio, 1.57 relative to PGV+/FPC−).

"Our interim analysis suggests that classifying HRIs into FPC, PGV+/FPC+, and PGV+/FPC− risk groups may have biologic relevance with clinical significance for tailored surveillance of HRIs," the authors write. "We recommend that this subclassification of HRIs be adopted by surveillance protocols moving forward."

The study was funded by Ambry Genetics, TrovaNOW, Amazon Web Services, Project Purple, REALM IDx, and Invicro, through the PRECEDE Consortium.

Abstract/Full Text

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