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Development of a Novel Protocol for Germline Testing in Pancreatic Cancer.
Hannah G McDonald1, Andrew Kennedy1, Angelica L Solomon1
1Division of Surgical Oncology, Department of Surgery, University of Kentucky, Lexington, KY, USA.
Annals of Surgical Oncology
|August 12, 2024
Summary
Physician-led germline genetic testing (GGT) for pancreatic cancer patients showed high compliance. This approach efficiently directs genetic counseling (GC) resources to patients with actionable results, optimizing care.
Area of Science:
- Oncology
- Genetics
- Medical Management
Background:
- Universal germline genetic testing (GGT) is recommended for pancreatic ductal adenocarcinoma (PDAC) patients.
- Traditional genetic counseling (GC) models face resource limitations.
- New approaches are needed to meet guideline demands efficiently.
Purpose of the Study:
- To evaluate a novel physician-led GGT protocol for PDAC patients.
- To assess the feasibility and compliance of the new protocol with limited GC resources.
Main Methods:
- A physician-led GGT protocol was implemented.
- Test kits were managed by the GC team, who maintained a database.
- Patients with pathogenic variants received comprehensive GC; others received brief calls.
Main Results:
- 310 patients (81.5%) completed GGT with high physician (82.6%) and patient (98.7%) compliance.
- Pathogenic variants were found in 14.2% of patients; 26.8% had variants of uncertain significance (VUS).
- Specific gene variants (e.g., BRCA1/2, ATM) were identified, with GC successfully contacting all positive cases.
Conclusions:
- The novel protocol effectively facilitated GGT and optimized GC resource allocation.
- This framework prioritizes comprehensive GC for patients with actionable genetic findings.
- Future efforts will focus on implementing cascade testing for high-risk family members.
