Genetics, Genomics and Emerging Molecular Therapies of Pancreatic Cancer

The number of cases of pancreatic cancers in 2019 in Poland was 3852 (approx. 2% of all cancers). The course of the disease is very fast, and the average survival time from the diagnosis is 6 months. Only <2% of patients live for 5 years from the diagnosis, 8% live for 2 years, and almost half live for only about 3 months. A family predisposition to pancreatic cancer occurs in about 10% of cases. Several oncogenes in which somatic changes lead to the development of tumours, including genes BRCA1/2 and PALB2, TP53, CDKN2A, SMAD4, MLL3, TGFBR2, ARID1A and SF3B1, are involved in pancreatic cancer. Between 4% and 10% of individuals with pancreatic cancer will have a mutation in one of these genes. Six percent of patients with pancreatic cancer have NTRK pathogenic fusion. The pathogenesis of pancreatic cancer can in many cases be characterised by homologous recombination deficiency (HRD)-cell inability to effectively repair DNA. It is estimated that from 24% to as many as 44% of pancreatic cancers show HRD. The most common cause of HRD are inactivating mutations in the genes regulating this DNA repair system, mainly BRCA1 and BRCA2, but also PALB2, RAD51C and several dozen others.

Gene Variants Related to Cardiovascular and Pulmonary Diseases May Correlate with Severe Outcome of COVID-19

Background: Severe outcomes of COVID-19 account for up to 15% of all cases. The study aims to check if any gene variants related to cardiovascular (CVD) and pulmonary diseases (PD) are correlated with a severe outcome of COVID-19 in a Polish cohort of COVID-19 patients. Methods: In this study, a subset of 747 samples from unrelated individuals collected across Poland in 2020 and 2021 was used and whole-genome sequencing was performed. Results: The GWAS analysis of SNPs and short indels located in genes related to CVD identified one variant significant in COVID-19 severe outcome in the HADHA gene, while for the PD gene panel, we found two significant variants in the DRC1 gene. In this study, both potentially protective and risk variants were identified, of which variants in the HADHA gene deserve the most attention. Conclusions: This is the first study reporting the association between the HADHA and DRC1 genetic variants and COVID-19 severe outcome based on the cohort WGS analysis. Although all the identified variants are localised in introns, they may be correlated and therefore inherited along with other risk variants, potentially causative to severe outcome of COVID-19 but not discovered yet.

A computed tomography assessment of femoral and acetabular bone changes after total hip arthroplasty

Using computed tomography-assisted (CT) osteodensitometry, we studied the bone changes that occurred in 12 patients at 2 weeks and again at 1 year after total hip arthroplasty with insertion of a press-fit acetabular cup and an uncemented femoral tapered stem. There was a greater decrease in full bone density (BD) lateral to the femoral stem when compared to the medial side, at the proximal end of the femur this difference was significant (-22.1% versus -16.2%) ( P<0.001). At the tip of the stem cortical BD had decreased between 2.3% and 1.9% only. Proximal to the cup, the cortical BD increased by about 3.4% ( P< or =0.05), while the full BD decreased markedly by 8% ( P< or =0.001). These changes represent a response to a decrease in regional bone stress induced by the presence of the press-fit implant, and this might be considered as retro-acetabular stress shielding. No focal bone resorption was found.