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The spectrum of genetic variants in hereditary pancreatic cancer includes Fanconi anemia genes

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Abstract

Approximately 5–10% of all pancreatic cancer patients carry a predisposing mutation in a known susceptibility gene. Since >90% of patients present with late stage disease, it is crucial to identify high risk individuals who may be amenable to early detection or other prevention. To explore the spectrum of hereditary pancreatic cancer susceptibility, we evaluated germline DNA from pancreatic cancer participants (n = 53) from a large hereditary cancer registry. For those without a known predisposition mutation gene (n = 49), germline next generation sequencing was completed using targeted capture for 706 candidate genes. We identified 16 of 53 participants (30%) with a pathogenic (P) or likely pathogenic (LP) variant that may be related to their hereditary pancreatic cancer predisposition; seven had mutations in genes associated with well-known cancer syndromes (13%) [ATM (2), BRCA2 (3), MSH2 (1), MSH6 (1)]. Many had mutations in Fanconi anemia complex genes [BRCA2 (3 participants), FANCF, FANCM]. Eight participants had rare protein truncating variants of uncertain significance with no other P or LP variants. Earlier age of pancreatic cancer diagnosis (57.5 vs 64.8 years) was indicative of possessing a P or LP variant, as was cancer family history (p values <0.0001). Our multigene panel approach for identifying known cancer predisposing genetic susceptibility in those at risk for hereditary pancreatic cancer may have direct applicability to clinical practice in cases with mutations in actionable genes. Future pancreatic cancer predisposition studies should include evaluation of the Fanconi anemia genes.

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Acknowledgements

The research reported in this publication was supported by the National Cancer Institute (NCI) of the National Institutes of Health (NIH) under award number P30CA33572 (Integrative Genomics and Bioinformatics Cores). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. The City of Hope Clinical Cancer Genomics Community Research Network and the Hereditary Cancer Research Registry was supported in part by the NCI NIH award number RC4CA153828 (PI: J. Weitzel). Other sources of support include: Breast Cancer Research Foundation (PI: J. Weitzel), Morris and Horowitz Families Professor (S. Neuhausen), 2015 STOP CANCER Research Career Development Award (PI: T. Slavin), and the Oxnard Foundation (PI: T. Slavin). We would like to thank all sites that contributed research effort to the Clinical Cancer Genomics Community Research Network as well as the patients who allow this research to be completed. We would like to thank Drs. Yuan Chun Ding and Yuan Yate-Ching for help accessing informatics resources. We would also like to thank the following research assistants: Tanya Chavez, Lily Van Tongeren, and Rosa Mejia.

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  1. Department of Population Sciences, City of Hope National Medical Center, 1500 E. Duarte Rd, Bldg. 173, Duarte, CA, 91010, USA

    Thomas P. Slavin, Susan L. Neuhausen, Bita Nehoray, Ilana Solomon, Christina Rybak, Kathleen Blazer, Aaron Adamson, Kai Yang, Sharon Sand, Nancy Guerrero-Llamas, Danielle Castillo, Josef Herzog, Shivali Raja & Jeffrey Weitzel

  2. HealthQuest, Dyson Center for Cancer Care, 45 Reade Place, Poughkeepsie, NY, 12603, USA

    Mariana Niell-Swiller

  3. Department of Molecular and Cellular Biology, City of Hope National Medical Center, 1500 E. Duarte Rd, Duarte, CA, 91010, USA

    Xiwei Wu & Shu Tao

  4. Division of Clinical Cancer Genetics, Department of Medical Oncology, City of Hope National Medical Center, 1500 E. Duarte Rd, Bldg. 173, Room # 131, Duarte, CA, 91010, USA

    Thomas P. Slavin, Vincent Chung & Jeffrey Weitzel

  5. Department of Surgery, City of Hope National Medical Center, 1500 E. Duarte Rd, Duarte, CA, 91010, USA

    Gagandeep Singh

  6. Harrington Cancer Center, 1500 Wallace Blvd, Amarillo, TX, 79106, USA

    Sue Nadesan

  7. St. Joseph Hospital, 1100 W Stewart Dr., Orange, CA, 92868, USA

    Sandra Brown

  8. University of Puerto Rico, Paseo Dr. Jose Celso Barbosa, San Juan, 00921, Puerto Rico

    Marcia Cruz-Correa

  9. Mayo Clinic, 216 2nd St. SW, Rochester, MN, 55902, USA

    Gloria M. Petersen

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  1. Thomas P. Slavin
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Correspondence to Thomas P. Slavin.

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Slavin, T.P., Neuhausen, S.L., Nehoray, B. et al. The spectrum of genetic variants in hereditary pancreatic cancer includes Fanconi anemia genes. Familial Cancer 17, 235–245 (2018). https://doi.org/10.1007/s10689-017-0019-5

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