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Erschienen in: Journal of Gastrointestinal Surgery 2/2020

19.11.2019 | 2019 SSAT Plenary Presentation

Role of Molecular Profiling of Pancreatic Cancer After Neoadjuvant Therapy: Does it Change Practice?

verfasst von: Ashley N. Krepline, Lindsay Bliss, Jennifer Geurts, Idayat Akinola, Kathleen K. Christians, Ben George, Paul S. Ritch, William A. Hall, Beth A. Erickson, Douglas B. Evans, Susan Tsai

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 2/2020

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Abstract

Introduction

Tumor profiling can improve the selection of oncologic therapies in patients with pancreatic cancer (PC). The impact of neoadjuvant therapy on tumor testing is unknown.

Methods

Molecular profiling using commercially available 53-, 315-, or 472-gene next generation sequencing (NGS) panels was performed on surgical specimens following neoadjuvant therapy. All specimens with 472-gene sequencing also had immunohistochemical (IHC) testing. Treatment recommendations were based on somatic variants and IHC staining.

Results

NGS was performed on 74 patient specimens: 42 (57%) with a 472-gene panel, 28 (38%) with a 315-gene panel, 3 (4%) had 472- and 315-gene panels, and 1 (1%) patient had 53- and 472-gene panels (78 total tests). Likely pathogenic/pathogenic variants were identified in 73 (94%) of the 78 tests. Of the 73 samples with variants identified, 13 (18%) variants were associated with an actionable treatment: ATM (n = 10), BRCA1 (n = 1), PIK3CA (n = 1), and BRCA2 (n = 1). No patient had more than one actionable variant. Based on NGS results, the most commonly recommended therapy was a platinum agent (n = 12/78, 15%). Of the 46 specimens that underwent IHC analysis, overlapping chemotherapeutic treatment recommendations were identified in 40 (87%) specimens.

Conclusion

Using current multigene NGS panels, actionable variants were identified in 13 (18%) of 74 surgical specimens and primarily involved genes of the DNA repair pathway. Anecdotal reproducibility of test concordance was low.
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Metadaten
Titel
Role of Molecular Profiling of Pancreatic Cancer After Neoadjuvant Therapy: Does it Change Practice?
verfasst von
Ashley N. Krepline
Lindsay Bliss
Jennifer Geurts
Idayat Akinola
Kathleen K. Christians
Ben George
Paul S. Ritch
William A. Hall
Beth A. Erickson
Douglas B. Evans
Susan Tsai
Publikationsdatum
19.11.2019
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 2/2020
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-019-04423-6

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