Utilization and Outcomes of Multigene Panel Testing in Patients With Pancreatic Ductal Adenocarcinoma

Derk C F Klatte ^1,2, Jason S Starr ³, Kristin E Clift ¹

⁰Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL.

Jco Oncology Practice +

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April 15, 2024

View abstract on PubMed

Summary

Germline genetic testing (GT) for pancreatic cancer (PDAC) is underutilized despite guidelines. Increased GT can identify hereditary cancer risks for patients and families, improving surveillance and support.

Area Of Science

Oncology
Genetics
Cancer Research

Background

National Comprehensive Cancer Network guidelines recommend germline genetic testing (GT) for pancreatic ductal adenocarcinoma (PDAC) patients.
Multigene panel testing offers comprehensive evaluation for hereditary cancer predispositions.

Purpose Of The Study

To evaluate the utilization and outcomes of multigene panel GT in PDAC patients.
To assess the impact of updated guidelines on GT discussion and uptake.

Main Methods

Retrospective, multisite study of 533 PDAC patients diagnosed between May 2018 and August 2020.
Comparison of GT discussion and performance rates before and after guideline updates.
Analysis of factors associated with GT utilization and pathogenic variant detection.

Main Results

GT was discussed in 34.3% preguideline and 39.6% postguideline; performed in 80.9% and 75.0% respectively.
Pathogenic variants (PVs) were identified in 17.1% of tested patients, with 11.2% associated with PDAC.
GT was more likely in younger patients, those seen by medical oncologists, and survivors >12 months.

Conclusions

Germline genetic testing for PDAC remains underutilized despite recommendations.
Increased GT utilization is crucial for identifying hereditary risks, enabling surveillance and support for patients and families.
Efforts to improve GT uptake are needed given the implications for patient management and family screening.