Evidence map›Paper›PMID 39133448›Full record

ArticleAnnals of surgical oncology2024

Development of a Novel Protocol for Germline Testing in Pancreatic Cancer.

Hannah G McDonald, Andrew Kennedy, Angelica L Solomon, Chelsey M Williams, Anna M Reagan, Emily Cassim, Megan Harper, Erin Burke, Terra Armstrong, Michael Gosky and 10 more

Abstract read
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In one paragraph

Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Hannah G McDonald *Division of Surgical Oncology, Department of Surgery, University of Kentucky, Lexington, KY, USA.
Andrew Kennedy *Division of Surgical Oncology, Department of Surgery, University of Kentucky, Lexington, KY, USA.
Angelica L SolomonDivision of Surgical Oncology, Department of Surgery, University of Kentucky, Lexington, KY, USA.
Chelsey M WilliamsDivision of Hematology Oncology, Department of Medicine, University of Kentucky, Lexington, KY, USA.
Anna M ReaganDivision of Surgical Oncology, Department of Surgery, University of Kentucky, Lexington, KY, USA.
Emily CassimDivision of Surgical Oncology, Department of Surgery, University of Kentucky, Lexington, KY, USA.
Megan HarperDivision of Surgical Oncology, Department of Surgery, University of Kentucky, Lexington, KY, USA.
Erin BurkeDivision of Surgical Oncology, Department of Surgery, University of Kentucky, Lexington, KY, USA.
Terra ArmstrongMarkey Cancer Center, University of Kentucky, Lexington, KY, USA.
Michael GoskyMarkey Cancer Center, University of Kentucky, Lexington, KY, USA.
Michael CavnarDivision of Surgical Oncology, Department of Surgery, University of Kentucky, Lexington, KY, USA.
Prakash K PandalaiDivision of Surgical Oncology, Department of Surgery, University of Kentucky, Lexington, KY, USA.
Mautin Barry-HundeyinDivision of Surgical Oncology, Department of Surgery, University of Kentucky, Lexington, KY, USA.
Reema PatelDivision of Hematology Oncology, Department of Medicine, University of Kentucky, Lexington, KY, USA.
Snigdha NutalapatiDivision of Hematology Oncology, Department of Medicine, University of Kentucky, Lexington, KY, USA.
Jessica MossDivision of Hematology Oncology, Department of Medicine, University of Kentucky, Lexington, KY, USA.
Pamela C HullDepartment of Behavioral Science, University of Kentucky, Lexington, KY, USA.
Jill KolesarCollege of Pharmacy, University of Kentucky, Lexington, KY, USA.
Justine C PickarskiMarkey Cancer Center, University of Kentucky, Lexington, KY, USA.
Joseph KimDivision of Surgical Oncology, Department of Surgery, University of Kentucky, Lexington, KY, USA. joseph.kim@uky.edu.

Funding

Oncology Research Training for Surgeon-ScientistsT32CA160003 · NCI · UNIVERSITY OF KENTUCKY · PI Bernard Mark Evers, Pamela Carmen Hull · 2011 to 2026
$3.2M
NCI NIH HHS T32 CA160003NIH HHS NIH T32CA60003
6 · The paper itself

Abstract

backgroundGuidelines now recommend universal germline genetic testing (GGT) for all pancreatic ductal adenocarcinoma (PDAC) patients. Testing provides information on actionable pathogenic variants and guides management of patients and family. Since traditional genetic counseling (GC) models are time-intensive and GC resources are sparse, new approaches are needed to comply with guidelines without overwhelming available resources.

methodsA novel protocol was developed for physician-led GGT. Completed test kits were delivered to the GC team, who maintained a prospective database and mailed all orders. If results revealed pathogenic variants for PDAC, patients were offered comprehensive GC, whereas negative and variant of uncertain significance (VUS) test results were reported to patients via brief calls.

resultsDuring protocol implementation between January 2020 and December 2022, 310 (81.5%) patients underwent GGT, with a physician compliance rate of 82.6% and patient compliance rate of 98.7%. Of 310 patients tested, 44 (14.2%) patients had detection of pathogenic variants, while 83 (26.8%) patients had VUS. Pathogenic variants included BRCA1/BRCA2/PALB2 (n = 18, 5.8%), ATM (n = 9, 2.9%), CFTR (n = 4, 1.3%), EPCAM/MLH1/MSH2/MSH6/PMS2 (n = 3, 1.0%), and CDKN2A (n = 2, 0.7%). The GC team successfully contacted all patients with pathogenic variants to discuss results and offer comprehensive GC.

conclusionOur novel protocol facilitated GGT with excellent compliance despite limited GC resources. This framework for GGT allocates GC resources to those patients who would benefit most from GC. As we continue to expand the program, we seek to implement methods to ensure compliance with cascade testing of high-risk family members.

Indexed as

Carcinoma, Pancreatic DuctalGenetic TestingGerm-Line MutationPancreatic NeoplasmsAdultAgedBiomarkers, TumorClinical ProtocolsFemaleFollow-Up StudiesGenetic CounselingGenetic Predisposition to DiseaseHumansMaleMiddle AgedPrognosisBiomarkers, TumorGenetic counselingGermline genetic testingPDACPhysician-led genetic testingUniversal genetic testing

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.