Hereditary vs Familial Pancreatic Cancer: Associated Genetic Syndromes and Clinical Perspective

Oncology (Williston Park). 2020 Jun 10;34(6):196-201.

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is a disease marked by high rates of mortality; it is mostly incurable at the time of diagnosis. Only about 7% of patients survive 5 years after diagnosis. Diagnosis at a late stage and rapid progression with minimal response to available treatments are the main reasons for this poor outcome. It is crucial to identify individuals at high risk of developing PDAC so preventive and early detection measures can be employed. Approximately 10% to 15% of PDAC cases have a hereditary or familial basis. In the majority of PDAC cases, no main causative gene has been identified, but several known germline pathogenic mutations have been shown to be related to an increased risk of this cancer. The presence of 2 or more patients with pancreatic cancer within the circle of first-degree relatives, without the presence of a causative germline mutation, is defined as familial pancreatic cancer; this accounts for 4% to 10% of PDAC. Based on the growing evidence supporting the benefit of germline genetic testing in patients with PDAC, both the American Society of Clinical Oncology and the National Comprehensive Cancer Network recently updated their guidelines to include recommendations around genetic testing for patients with pancreatic cancer. However, there is no general consensus on the group of patients and individuals who should be studied and screened. We present a demonstrative case and review the available data on hereditary and familial PDAC.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoma / diagnostic imaging
  • Carcinoma / genetics*
  • Carcinoma / therapy
  • Carcinoma, Pancreatic Ductal / diagnostic imaging
  • Carcinoma, Pancreatic Ductal / genetics*
  • Carcinoma, Pancreatic Ductal / therapy
  • Genetic Testing / methods
  • Germ-Line Mutation*
  • Humans
  • Male
  • Neoplastic Syndromes, Hereditary / diagnostic imaging
  • Neoplastic Syndromes, Hereditary / genetics
  • Neoplastic Syndromes, Hereditary / pathology
  • Pancreatectomy / methods
  • Pancreatic Neoplasms / diagnostic imaging
  • Pancreatic Neoplasms / genetics*
  • Pancreatic Neoplasms / therapy
  • Risk Factors

Supplementary concepts

  • Pancreatic carcinoma, familial