Abstract 352P
Background
Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer-related deaths worldwide.10-15% of PDACs are attributable to inherited genetic alterations. Identification of such variants may enhance targeted screening and inform treatment decisions like the utilization of poly ADP-ribose polymerase (PARP) inhibitors in patients with BRCA variants. International guidelines recommend testing all patients with PDAC. Data on Middle Eastern population is lacking.
Methods
This prospective study included adult patients with PDAC treated at King Hussein Cancer Center in Amman, Jordan between Jan 2020 and Dec 2023. All patients underwent next generation sequencing (NGS)-based multigene panel testing (MGP). Cascade family testing was offered to first and second-degree relatives for patients with positive results. Descriptive analysis was performed using Stata software, version 18.
Results
A total of 186 patients; 97.3% had PDAC as their first cancer upon study enrollment, were included in the analysis. The median age at diagnosis was 59 years, and 61.3% were males. 146 (78.5%) had family history of malignancy (any) and 5.9% developed second malignancies after initial PDAC diagnosis. Patients underwent MGP testing using a standard 10 or 18-gene panel (n=118, 63.4%) or an investigational 84-gene panel (n=68, 36.6%). In total, 20 (10.8%) patients had positive mutations; 12 (6.5%) as pathogenic/likely pathogenic variants, mostly in BRCA2 (n=6), while 8 others (4.3%) had increased risk allele in APC. Other variants identified included CHEK2 (n=2), BRCA1, CFTR, ATM and TP53 (one each). Only 5 (25.5%) patients communicated results with their relatives; 12 (66.7%) of 18 relatives tested had positive results, and one was diagnosed with breast cancer at screening.
Conclusions
Our study underscores the relevance of PDAC germline genetic testing among the Middle Eastern population. Given its clinical implication for screening and management, universal testing should be advocated. Communicating test results with at-risk relatives, despite its implications, is suboptimal and worth investigation.
Legal entity responsible for the study
King Hussein Cancer Center.
Funding
King Hussein Cancer Center.
Disclosure
All authors have declared no conflicts of interest.