Referral frequency, attrition rate, and outcomes of germline testing in patients with pancreatic adenocarcinoma

AbstractHereditary predisposition is estimated to account for 10% of all pancreatic cancer cases. However, referral patterns and clinical workflow for germline testing in this disease differ significantly by institution, and many at-risk patients may not undergo appropriate counseling and testing. We undertook an analysis of patients diagnosed with pancreatic cancer (PDAC) who were referred to the Clinical Genetics program of a high-volume academic center over a 3-year period to assess referral frequency, evaluate the yield of germline testing in this selected patient cohort, and elucidate the reasons individuals did not undergo recommended germline testing. Medical records of patients with PDAC referred for genetic counseling between January 2015 and October 2017 were reviewed for demographic, medical/family history, and disease-specific data. If testing did not occur, reasons were documented. Genetic test results were categorized as negative, variants of unknown significance, or established pathogenic mutations. Descriptive statistics included means with standard deviations; associations were analyzed witht test and Fisher ’s exact test. 32% (137 of 432) of PDAC patients were referred for genetic counseling, but only 64% attended their appointment and 60% ultimately underwent germline testing. Common reasons for attrition included worsening disease severity, lack of patient follow-up, insurance concerns, and logisti c/travel challenges. Pathogenic germline mutations w...
Source: Familial Cancer - Category: Cancer & Oncology Source Type: research

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ConclusionsThis targeted methylation assay detected cancer signal across>20 cancer types with a single, fixed, low false positive rate and highly accurate TOO localization. These data support the feasibility of a single test that can screen for multiple cancers.Clinical trial identificationNCT02889978, NCT03085888.Editorial acknowledgementSarah Prins, PhD (GRAIL, Inc.), and Megan P. Hall, PhD (GRAIL, Inc.).Legal entity responsible for the studyGRAIL, Inc.FundingGRAIL, Inc.DisclosureG.R. Oxnard: Advisory / Consultancy, Officer / Board of Directors: Inivata; Honoraria (self): Guardant Health; Honoraria (self): Sysmex; Hon...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal malignancies worldwide, associated with poor prognosis even when diagnosed at an early clinical stage (CS). Despite advances in surgery, radiotherapy, and chemotherapy, the 5-year overall survival rate is only 7.0-8.5% [1]. FOLFIRINOX (5-fluorouracil, irinotecan, and oxaliplatin) and nab-paclitaxel plus gemcitabine are first-line treatment options in the metastatic setting, with a median overall survival of less than 1 year [2,3].
Source: Cancer Treatment Reviews - Category: Cancer & Oncology Authors: Tags: Systematic or Meta-analysis Studies Source Type: research
The endothelium could be a potential target of cancer cell derived extracellular vesicles (CaCe-dEV). We investigated in vitro the effect of CaCe-dEV on the hemostatic balance of endothelial cells. Extracellular vesicles released from pancreas adenocarcinoma cells (BXPC3) or human breast cancer cells (MCF7) were isolated by differential centrifugation. Human umbilical vein endothelial cells (HUVEC) were cultured for 72  h in the presence or absence of CaCe-dEV. Subsequently, they were washed and re-cultivated over three cycles to get daughter cell generations (DG) which were not exposed to CaCe-dEV.
Source: Thrombosis Research - Category: Hematology Authors: Tags: Full Length Article Source Type: research
Abstract Myoferlin, a protein of the ferlin family, has seven C2 domains and exhibits activity in some cells, including myoblasts and endothelial cells. Recently, myoferlin was identified as a promising target and biomarker in non-small-cell lung cancer, breast cancer, pancreatic adenocarcinoma, hepatocellular carcinoma, colon cancer, melanoma, oropharyngeal squamous cell carcinoma, head and neck squamous cell carcinoma, clear cell renal cell carcinoma and endometrioid carcinoma. This evidence indicated that myoferlin was involved in the proliferation, invasion and migration of tumour cells, the mechanism of which...
Source: J Cell Mol Med - Category: Molecular Biology Authors: Tags: J Cell Mol Med Source Type: research
Abstract With the increasing awareness of heterogeneity in cancers, better prediction of cancer prognosis is much needed for more personalized treatment. Recently, extensive efforts have been made to explore the variations in gene expression for better prognosis. However, the prognostic gene signatures predicted by most existing methods have little robustness among different datasets of the same cancer. To improve the robustness of the gene signatures, we propose a novel high-frequency sub-pathways mining approach (HiFreSP), integrating a randomization strategy with gene interaction pathways. We identified a six-g...
Source: Briefings in Bioinformatics - Category: Bioinformatics Authors: Tags: Brief Bioinform Source Type: research
AbstractBreast cancer is known to metastasize to all organs of the body. However, abdominal lymph node metastases from breast cancer are extremely rare. We herein report a resected case of an invasive pancreatic ductal adenocarcinoma (PDAC) in which abdominal lymph node metastases from breast cancer were diagnosed. A 54-year-old woman was pointed out to have a tumor in the pancreatic tail with dilatation of the distal pancreatic duct. She had undergone partial mastectomy for left breast cancer at the age of 51  years and had undergone partial liver resection for liver metastasis in the segment 3/4 6 months earlie...
Source: International Cancer Conference Journal - Category: Cancer & Oncology Source Type: research
In 2016 pancreatic cancer (PC) moved from 4th[1,2] to 3rd leading cause of cancer death in the US, surpassing breast cancer[3]. PC is projected to be the second leading cause of cancer related death in 2020[4,5]. Over 90% of PC cases develop in the exocrine tissue. Pancreatic adenocarcinomas compromise most of the exocrine tumors and of these the pancreatic ductal adenocarcinoma (PDAC) is the most frequent histological subtype[6]. About half of patients with PC present with distant metastases while approximately a third present with locally advanced disease[7].
Source: Cancer Treatment Reviews - Category: Cancer & Oncology Authors: Tags: Systematic or Meta-analysis Studies Source Type: research
Conclusions: The combination of ibrutinib 560 mg daily and durvalumab 10 mg/kg every 2 weeks had an acceptable safety profile. The antitumor activity of the ibrutinib-durvalumab combination was limited in our study population.Oncology
Source: Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSIONS: The combination of ibrutinib 560 mg daily and durvalumab 10 mg/kg every 2 weeks had an acceptable safety profile. The antitumor activity of the ibrutinib-durvalumab combination was limited in our study population. PMID: 31230047 [PubMed - as supplied by publisher]
Source: Oncology - Category: Cancer & Oncology Authors: Tags: Oncology Source Type: research
Portal vein (PV) circulating tumor cells (CTCs) and elevated peripheral blood (PB) levels of biomarkers have been associated with poor outcomes in pancreatic ductal adenocarcinoma (PDAC). Although transforming growth factor-beta (TGF β) is associated with CTCs in breast cancer, there are limited data evaluating a comprehensive biomarker panel and CTCs in PDAC patients. The authors hypothesized that tumor progression biomarkers would be associated with PV CTCs.
Source: Journal of Surgical Research - Category: Surgery Authors: Tags: Gastrointestinal Source Type: research
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