Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting
Abstract Background Genetic testing is recommended for all pancreatic ductal adenocarcinoma (PDAC) patients. Prior research demonstrates that multidisciplinary pancreatic cancer clinics (MDPCs) improve treatment‐ and survival‐related outcomes for PDAC patients. However, limited information exists re...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-02-01
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| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.5059 |
| _version_ | 1826964123835957248 |
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| author | Jessica N. Everett Shenin A. Sanoba Xiaohong Jing Cody Stender Madeleine Schmitter Ariele Baptiste Jennifer Chun Emily A. Kawaler Lauren G. Khanna Seth A. Gross Tamas A. Gonda Nina Beri Paul E. Oberstein Diane M. Simeone |
| author_facet | Jessica N. Everett Shenin A. Sanoba Xiaohong Jing Cody Stender Madeleine Schmitter Ariele Baptiste Jennifer Chun Emily A. Kawaler Lauren G. Khanna Seth A. Gross Tamas A. Gonda Nina Beri Paul E. Oberstein Diane M. Simeone |
| author_sort | Jessica N. Everett |
| collection | DOAJ |
| description | Abstract Background Genetic testing is recommended for all pancreatic ductal adenocarcinoma (PDAC) patients. Prior research demonstrates that multidisciplinary pancreatic cancer clinics (MDPCs) improve treatment‐ and survival‐related outcomes for PDAC patients. However, limited information exists regarding the utility of integrated genetics in the MDPC setting. We hypothesized that incorporating genetics in an MDPC serving both PDAC patients and high‐risk individuals (HRI) could: (1) improve compliance with guideline‐based genetic testing for PDAC patients, and (2) optimize HRI identification and PDAC surveillance participation to improve early detection and survival. Methods Demographics, genetic testing results, and pedigrees were reviewed for PDAC patients and HRI at one institution over 45 months. Genetic testing analyzed 16 PDAC‐associated genes at minimum. Results Overall, 969 MDPC subjects were evaluated during the study period; another 56 PDAC patients were seen outside the MDPC. Among 425 MDPC PDAC patients, 333 (78.4%) completed genetic testing; 29 (8.7%) carried a PDAC‐related pathogenic germline variant (PGV). Additionally, 32 (9.6%) met familial pancreatic cancer (FPC) criteria. These PDAC patients had 191 relatives eligible for surveillance or genetic testing. Only 2/56 (3.6%) non‐MDPC PDAC patients completed genetic testing (p < 0.01). Among 544 HRI, 253 (46.5%) had a known PGV or a designation of FPC, and were eligible for surveillance at baseline; of the remainder, 15/291 (5.2%) were eligible following genetic testing and PGV identification. Conclusion Integrating genetics into the multidisciplinary setting significantly improved genetic testing compliance by reducing logistical barriers for PDAC patients, and clarified cancer risks for their relatives while conserving clinical resources. Overall, we identified 206 individuals newly eligible for surveillance or genetic testing (191 relatives of MDPC PDAC patients, and 15 HRI from this cohort), enabling continuity of care for PDAC patients and at‐risk relatives in one clinic. |
| first_indexed | 2024-04-10T09:27:15Z |
| format | Article |
| id | doaj.art-0f6a7df4ed6f4128a0db53d3b8d92eac |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2025-02-18T02:56:36Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-0f6a7df4ed6f4128a0db53d3b8d92eac2024-11-25T07:56:31ZengWileyCancer Medicine2045-76342023-02-011232345235510.1002/cam4.5059Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic settingJessica N. Everett0Shenin A. Sanoba1Xiaohong Jing2Cody Stender3Madeleine Schmitter4Ariele Baptiste5Jennifer Chun6Emily A. Kawaler7Lauren G. Khanna8Seth A. Gross9Tamas A. Gonda10Nina Beri11Paul E. Oberstein12Diane M. Simeone13Department of Medicine New York University Langone Health New York City New York USAPerlmutter Cancer Center New York University Langone Health New York City New York USAPerlmutter Cancer Center New York University Langone Health New York City New York USAPerlmutter Cancer Center New York University Langone Health New York City New York USAPerlmutter Cancer Center New York University Langone Health New York City New York USAPerlmutter Cancer Center New York University Langone Health New York City New York USAPerlmutter Cancer Center New York University Langone Health New York City New York USAApplied Bioinformatics Laboratories New York University Langone Health New York City New York USADepartment of Medicine New York University Langone Health New York City New York USADepartment of Medicine New York University Langone Health New York City New York USADepartment of Medicine New York University Langone Health New York City New York USADepartment of Medicine New York University Langone Health New York City New York USADepartment of Medicine New York University Langone Health New York City New York USADepartment of Medicine New York University Langone Health New York City New York USAAbstract Background Genetic testing is recommended for all pancreatic ductal adenocarcinoma (PDAC) patients. Prior research demonstrates that multidisciplinary pancreatic cancer clinics (MDPCs) improve treatment‐ and survival‐related outcomes for PDAC patients. However, limited information exists regarding the utility of integrated genetics in the MDPC setting. We hypothesized that incorporating genetics in an MDPC serving both PDAC patients and high‐risk individuals (HRI) could: (1) improve compliance with guideline‐based genetic testing for PDAC patients, and (2) optimize HRI identification and PDAC surveillance participation to improve early detection and survival. Methods Demographics, genetic testing results, and pedigrees were reviewed for PDAC patients and HRI at one institution over 45 months. Genetic testing analyzed 16 PDAC‐associated genes at minimum. Results Overall, 969 MDPC subjects were evaluated during the study period; another 56 PDAC patients were seen outside the MDPC. Among 425 MDPC PDAC patients, 333 (78.4%) completed genetic testing; 29 (8.7%) carried a PDAC‐related pathogenic germline variant (PGV). Additionally, 32 (9.6%) met familial pancreatic cancer (FPC) criteria. These PDAC patients had 191 relatives eligible for surveillance or genetic testing. Only 2/56 (3.6%) non‐MDPC PDAC patients completed genetic testing (p < 0.01). Among 544 HRI, 253 (46.5%) had a known PGV or a designation of FPC, and were eligible for surveillance at baseline; of the remainder, 15/291 (5.2%) were eligible following genetic testing and PGV identification. Conclusion Integrating genetics into the multidisciplinary setting significantly improved genetic testing compliance by reducing logistical barriers for PDAC patients, and clarified cancer risks for their relatives while conserving clinical resources. Overall, we identified 206 individuals newly eligible for surveillance or genetic testing (191 relatives of MDPC PDAC patients, and 15 HRI from this cohort), enabling continuity of care for PDAC patients and at‐risk relatives in one clinic.https://doi.org/10.1002/cam4.5059family historygenetic counselinggenetic testinggermline variantsmultidisciplinary carepancreatic cancer |
| spellingShingle | Jessica N. Everett Shenin A. Sanoba Xiaohong Jing Cody Stender Madeleine Schmitter Ariele Baptiste Jennifer Chun Emily A. Kawaler Lauren G. Khanna Seth A. Gross Tamas A. Gonda Nina Beri Paul E. Oberstein Diane M. Simeone Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting Cancer Medicine family history genetic counseling genetic testing germline variants multidisciplinary care pancreatic cancer |
| title | Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting |
| title_full | Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting |
| title_fullStr | Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting |
| title_full_unstemmed | Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting |
| title_short | Impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting |
| title_sort | impact of comprehensive family history and genetic analysis in the multidisciplinary pancreatic tumor clinic setting |
| topic | family history genetic counseling genetic testing germline variants multidisciplinary care pancreatic cancer |
| url | https://doi.org/10.1002/cam4.5059 |
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