Germinal BRCA1-2 pathogenic variants (gBRCA1-2pv) and pancreatic cancer: epidemiology of an Italian patient cohort

U. Peretti, A. Cavaliere, M. Niger, G. Tortora, M. C. Di Marco, M. G. Rodriquenz, F. Centonze, I. G. Rapposelli, G. Giordano, F. De Vita, L. Stuppia, A. Avallone, M. Ratti, C. Paratore, L. G. Forti, G. Orsi, M. M. Valente, M. Gaule, M. Macchini, P. CarreraS. Calzavara, M. Simbolo, D. Melisi, F. De Braud, L. Salvatore, S. De Lorenzo, C. Chiarazzo, M. Falconi, S. Cascinu, M. Milella, M. Reni

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Germline BRCA1-2 pathogenic variants (gBRCApv) increase the risk of pancreatic cancer and predict for response to platinating agents and poly(ADP-ribose) polymerase inhibitors. Data on worldwide gBRCApv incidence among pancreatic ductal adenocarcinoma (PDAC) patients are sparse and describe a remarkable geographic heterogeneity. The aim of this study is to analyze the epidemiology of gBRCApv in Italian patients. Materials and methods: Patients of any age with pancreatic adenocarcinoma, screened within 3 months from diagnosis for gBRCApv in Italian oncologic centers systematically performing tests without any selection. For the purposes of our analysis, breast, ovarian, pancreas, and prostate cancer in a patient's family history was considered as potentially BRCA-associated. Patients or disease characteristics were examined using the χ2 test or Fisher's exact test for qualitative variables and the Student's t-test or Mann–Whitney test for continuous variables, as appropriate. Results: Between June 2015 and May 2020, 939 patients were tested by 14 Italian centers; 492 (52%) males, median age 62 years (range 28-87), 569 (61%) metastatic, 273 (29%) with a family history of potentially BRCA-associated cancers. gBRCA1-2pv were found in 76 patients (8.1%; 9.1% in metastatic; 6.4% in non-metastatic). The gBRCA2/gBRCA1 ratio was 5.4: 1. Patients with gBRCApv were younger compared with wild-type (59 versus 62 years, P = 0.01). The gBRCApv rate was 17.1% among patients <40 years old, 10.4% among patients 41-50 years old, 9.2% among patients 51-60 years old, 6.7% among patients aged 61-70 years, and 6.2% among patients >70 years old (none out of 94 patients >73 years old). gBRCApv frequency in 845 patients <74 years old was 9%. Patients with/without a family history of potentially BRCA-associated tumors had 14%/6% mutations. Conclusion: Based on our findings of a gBRCApv incidence higher than expected in a real-life series of Italian patients with incident PDAC, we recommend screening all PDAC patients <74 years old, regardless of family history and stage, due to the therapeutic implications and cancer risk prevention in patients' relatives.

Original languageEnglish
Article number100032
JournalESMO Open
Volume6
Issue number1
DOIs
Publication statusPublished - Feb 2021

Keywords

  • epidemiology
  • familial cancer
  • germline BRCA
  • pancreatic cancer genetics

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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