1
|
Haimi I, Zogopoulos G, Dettwyler SA, Everett JN, Bi Y, Brand RE, Chung DC, Farrell JJ, Grossberg A, Kastrinos F, Katona BW, Klute K, Kupfer SS, Lucas AL, Paiella S, Parmigiani G, Permuth JB, Sears RC, Sussman DA, Simeone DM. Pancreatic imaging findings from the PRECEDE study: A large high-risk heritable cohort for pancreatic cancer. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.4_suppl.689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
689 Background: Pancreatic ductal adenocarcinoma (PDAC) is a highly lethal cancer typically discovered at incurable stages. The PRECEDE Consortium was established to accelerate early detection by using a large-scale, collaborative, innovative model, predicated on standardized collection of demographic, clinical, and imaging data from high-risk individuals (HRI). Here we report the initial pancreas imaging findings in Cohort 1, representing HRI with familial pancreatic cancer (FPC) or pathogenic germline variants (PGV) in PDAC susceptibility genes with a 1st or 2nd degree relative with PDAC. Methods: The PRECEDE Consortium (NCT04970056) began enrollment in 5/2020. HRI enrolled prospectively at centers worldwide into one of 7 cohorts based on personal and/or family history of PDAC and PGV status. PRECEDE’s planned enrollment is 10,000 patients. Data sharing is required to join PRECEDE, facilitated by a standardized data collection system and central database (PRECEDELink). Imaging (MRI/MRCP and EUS) is performed using standardized image acquisition and reporting templates. Imaging and clinical sequencing data are stored and analyzed in the PRECEDE data cloud. Results: By 9/16/2022, 26 sites enrolled 3156 patients in 7 cohorts, with 1716 in Cohort 1. Cohort 1 was 60% female, 80% white; 48% met FPC criteria, and 52% were PGV carriers. Within Cohort 1, 658 FPC and 965 PGV (1353 total, 79%) underwent imaging (68% MRI; 32% EUS). Overall, 573/1353 (42%) had pancreas abnormalities: 320/573 (49%) FPC, and 253/573 (36%) PGV (OR [95% CI] 1.65 [1.32–2.06], P < 0.001). Cysts were the most common abnormality, present in 549/1353 (41%) and accounting for 310/320 (97%) FPC and 239/253 (94%) PGV HRI abnormalities. Of 549 HRI with cysts, 262 (48%) had 1 cyst, including 137/310 (44%) FPC and 125/239 (52%) PGV HRI (OR 1.43 [1.07–1.92], P = .012) The remaining 287/549 (52%) had ≥2 cysts, including 173/310 (56%) FPC and 114/239 (48%) PGV HRI (OR 1.98 [1.49–2.64], P < 0.001). Worrisome features occurred in 83/1353 (6.1%) including: 14 (1%) cyst > 2 cm, 7 (0.5%) cyst ≥3 cm, 35 (2.6%) main pancreatic duct (MPD) diameter ≥5 mm; 2 (0.15%) duct strictures; and 25 (1.8%) solid masses. Solid masses included 1 (0.07%) PDAC, 9 (0.7%) neuroendocrine tumors, and 15 (1.1%) benign lesions (e.g. lipoma, splenule). Conclusions: Pancreatic abnormalities are common in a cohort of 1353 HRI enrolled in PRECEDE; 6.1% of HRI had findings with worrisome features and clinical implications. Multiple cysts were significantly more common in FPC HRI (OR 1.98); worrisome findings did not differ between FPC and PGV groups. The longitudinal study of this growing HRI cohort with standardized imaging and matched comprehensive epidemiological, clinical, and laboratory data, along with germline testing, will provide critical information and understanding of PDAC risk, and augment existing clinical decision-making models governing surveillance and treatment.
Collapse
Affiliation(s)
- Ido Haimi
- NYU Langone Health- Department of Surgery, New York, NY
| | | | | | | | - Yan Bi
- Mayo Clinic, Jacksonville, FL
| | | | | | | | | | | | - Bryson W Katona
- University of Pennsylvania Perelman School of Medicine (Philadelphia, PA), Philadelphia, PA
| | - Kelsey Klute
- University of Nebraska Medical Center, Omaha, NE
| | | | | | - Salvatore Paiella
- General and Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy
| | | | | | | | | | | | | |
Collapse
|
2
|
Solanky S, Khan S, Ejarque RA, Tosi I, Dawe H, Barker J, Di Meglio P, Consortium P. 096 IL23-induced STAT3 nuclear translocation in MAIT cells at baseline is a candidate biomarker of response to biologics targeting the IL23/IL17 axis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
3
|
Hardman-Smart J, Ejarque RA, Solanky S, Tosi I, Grys K, Barker J, Griffiths C, Reynolds N, Smith C, Warren R, Di Meglio P, Consortium P. 115 The frequency of intermediate monocytes before treatment is a candidate biomarker of clinical response to secukinumab in of psoriasis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
6
|
Solanky S, Ejarque RA, Tosi I, Dawe H, Mahil S, Smith C, Barker J, Consortium P, Di Meglio P. 051 STAT3 nuclear translocation in circulating MAIT cells is a potential biomarker of clinical outcome to ustekinumab in psoriasis. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.08.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|