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Brain Metastases in Pancreatic Ductal Adenocarcinoma: Assessment of Molecular Genotype-Phenotype Features-An Entity With an Increasing Incidence?

Publication ,  Journal Article
Jordan, EJ; Lowery, MA; Basturk, O; Allen, PJ; Yu, KH; Tabar, V; Beal, K; Reidy, DL; Yamada, Y; Janjigian, Y; Abou-Alfa, GK; O'Reilly, EM
Published in: Clin Colorectal Cancer
June 2018

PURPOSE: To assess clinical characteristics of patients with metastatic pancreas ductal adenocarcinoma (PDAC) and brain metastases (BM), and to assess somatic and germ-line molecular profiles where performed. PATIENTS AND METHODS: Patients with PDAC and BM between January 1990 and January 2016 were identified. Molecular characteristics of somatic and germ-line testing where performed in the subset of patients who had provided informed consent. Somatic alterations were assessed by either MSK-IMPACT testing (>340 key cancer genes) or Sequenom testing (8-gene panel). Overall survival was calculated from date of diagnosis to either date of last follow-up or death. Survival after BM was calculated from date of diagnosis of BM by radiology or pathology to either date of last follow-up or death. RESULTS: From a total of 5824 patients with PDAC identified from January 2000 to January 2016, twenty-five patients (0.4%) had BM. Median age at PDAC diagnosis was 58 years. Median time to the development of BM from initial PDAC diagnosis was 17 months (range, 0-79 months). Median overall survival after BM diagnosis was 1.5 months (range, 1-31 months). Overall survival for patients who had craniotomy (n = 4) was 11 months (range, 1-31 months), with 2 long-term survivors at 21 and 31 months, respectively. Four patients had leptomeningeal disease. Six of 25 patients had germ-line testing, and 3 had BRCA mutations (2 BRCA1 and 1 BRCA2). Somatic profiling identified KRAS mutations in 100% (4 G12D, 2 G12V, and 1 Q61K). CONCLUSION: BM from PDAC is a rare event. We identified a speculative association of germ-line BRCA1/2 alterations with BM in PDAC, which requires corroboration. Survival after BM development is poor; prolonged survival occurred in selected patients via a multidisciplinary approach.

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Published In

Clin Colorectal Cancer

DOI

EISSN

1938-0674

Publication Date

June 2018

Volume

17

Issue

2

Start / End Page

e315 / e321

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Incidence
  • Humans
  • Germ-Line Mutation
  • Genetic Association Studies
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Jordan, E. J., Lowery, M. A., Basturk, O., Allen, P. J., Yu, K. H., Tabar, V., … O’Reilly, E. M. (2018). Brain Metastases in Pancreatic Ductal Adenocarcinoma: Assessment of Molecular Genotype-Phenotype Features-An Entity With an Increasing Incidence? Clin Colorectal Cancer, 17(2), e315–e321. https://doi.org/10.1016/j.clcc.2018.01.009
Jordan, Emmet J., Maeve A. Lowery, Olca Basturk, Peter J. Allen, Kenneth H. Yu, Viviane Tabar, Kathryn Beal, et al. “Brain Metastases in Pancreatic Ductal Adenocarcinoma: Assessment of Molecular Genotype-Phenotype Features-An Entity With an Increasing Incidence?Clin Colorectal Cancer 17, no. 2 (June 2018): e315–21. https://doi.org/10.1016/j.clcc.2018.01.009.
Jordan EJ, Lowery MA, Basturk O, Allen PJ, Yu KH, Tabar V, et al. Brain Metastases in Pancreatic Ductal Adenocarcinoma: Assessment of Molecular Genotype-Phenotype Features-An Entity With an Increasing Incidence? Clin Colorectal Cancer. 2018 Jun;17(2):e315–21.
Jordan, Emmet J., et al. “Brain Metastases in Pancreatic Ductal Adenocarcinoma: Assessment of Molecular Genotype-Phenotype Features-An Entity With an Increasing Incidence?Clin Colorectal Cancer, vol. 17, no. 2, June 2018, pp. e315–21. Pubmed, doi:10.1016/j.clcc.2018.01.009.
Jordan EJ, Lowery MA, Basturk O, Allen PJ, Yu KH, Tabar V, Beal K, Reidy DL, Yamada Y, Janjigian Y, Abou-Alfa GK, O’Reilly EM. Brain Metastases in Pancreatic Ductal Adenocarcinoma: Assessment of Molecular Genotype-Phenotype Features-An Entity With an Increasing Incidence? Clin Colorectal Cancer. 2018 Jun;17(2):e315–e321.
Journal cover image

Published In

Clin Colorectal Cancer

DOI

EISSN

1938-0674

Publication Date

June 2018

Volume

17

Issue

2

Start / End Page

e315 / e321

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Incidence
  • Humans
  • Germ-Line Mutation
  • Genetic Association Studies
  • Female