Recommendations for a More Organized and Effective Approach to the Early Detection of Pancreatic Cancer From the PRECEDE (Pancreatic Cancer Early Detection) Consortium

Gonda, Tamas A.; Everett, Jessica N.; Wallace, Michael B.; Simeone, Diane M.

doi:10.1053/j.gastro.2021.08.036

Cited by 24 publications

(15 citation statements)

References 31 publications

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“…Despite an overall low incidence, pancreatic cancer is aggressive and therefore the second leading cause of cancer death with currently no approved population-based screening test. As such, PC is a prime target for precision-based early detection [16 ▪ ,17].…”

Section: Redefining Early Cancer Detection Strategiesmentioning

confidence: 99%

Early Detection of Cancers in the Era of Precision Oncology

Tan

Sharma

Das

et al. 2023

Current Opinion in Oncology

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Purpose of reviewThe increasing global incidence of cancer demands innovative cancer detection modalities. The current population-based early cancer detection approaches focus on several major types of cancers (breast, prostate, cervical, lung and colon) at their early stages, however, they generally do not target high-risk individuals at precancerous stages. Recent findingsSome cancers, such as pancreatic cancer, are challenging to detect in their early stages. Therefore, there is a pressing need for improved, accessible, noninvasive, and cost-effective early detection methods. Harnessing cell-free-based biomarker-driven strategies paves a new era of precision diagnosis for multicancer early detection. The majority of these tests are in the early stages and expensive, but these approaches are expected to become cost sensitive in the near future. SummaryThis review provides an overview of early cancer detection strategies, highlighting the methods, challenges, and issues to be addressed to revolutionize and improve global early cancer detection.

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Section: Redefining Early Cancer Detection Strategiesmentioning

confidence: 99%

Early Detection of Cancers in the Era of Precision Oncology

Tan

Sharma

Das

et al. 2023

Current Opinion in Oncology

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“…PDAC surveillance is challenging, and it should not disregard the genetic background of all individuals at risk of PDAC. Ongoing multicenter studies, such as that of the Pancreatic Cancer Early Detection Consortium (PRECEDE), enrolling thousands of individuals at risk of PDAC [60] aims to assess who should be under surveillance and if surveillance ultimately reduces mortality.…”

Section: Preventative Implicationsmentioning

confidence: 99%

Germline Aberrations in Pancreatic Cancer: Implications for Clinical Care

Casolino

Corbo

Beer

et al. 2022

Cancers

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Pancreatic ductal adenocarcinoma (PDAC) has an extremely poor prognosis and represents a major public health issue, as both its incidence and mortality are expecting to increase steeply over the next years. Effective screening strategies are lacking, and most patients are diagnosed with unresectable disease precluding the only chance of cure. Therapeutic options for advanced disease are limited, and the treatment paradigm is still based on chemotherapy, with a few rare exceptions to targeted therapies. Germline variants in cancer susceptibility genes—particularly those involved in mechanisms of DNA repair—are emerging as promising targets for PDAC treatment and prevention. Hereditary PDAC is part of the spectrum of several syndromic disorders, and germline testing of PDAC patients has relevant implications for broad cancer prevention. Germline aberrations in BRCA1 and BRCA2 genes are predictive biomarkers of response to poly(adenosine diphosphate–ribose) polymerase (PARP) inhibitor olaparib and platinum-based chemotherapy in PDAC, while mutations in mismatch repair genes identify patients suitable for immune checkpoint inhibitors. This review provides a timely and comprehensive overview of germline aberrations in PDAC and their implications for clinical care. It also discusses the need for optimal approaches to better select patients for PARP inhibitor therapy, novel therapeutic opportunities under clinical investigation, and preclinical models for cancer susceptibility and drug discovery.

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“…multicenter consortia. [2][3][4][5] Cancer surveillance may result in psychological and physical distress, screening-related complications, false positivity, overdiagnosis, and overtreatment. 6 For pancreatic cancer surveillance, these aspects can be even more relevant.…”

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confidence: 99%

Surveillance of Individuals at High Risk of Developing Pancreatic Cancer

Paiella,

Secchettin,

Lionetto

et al. 2023

Annals of Surgery

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Objective: To quantify the rate of low-yield surgery, defined as no high-grade dysplastic precursor lesions or T1N0M0 pancreatic cancer at pathology, during pancreatic cancer surveillance. Summary Background Data: Global efforts have been made in pancreatic cancer surveillance to anticipate the diagnosis of pancreatic cancer at an early stage and improve survival in high-risk individuals (HRI) with a hereditary predisposition. The negative impact of pancreatic cancer surveillance when surgery is performed for low-grade dysplasia or a non-neoplastic condition is not well-quantified. Methods: A systematic search and prevalence meta-analysis was performed for studies reporting surgery with final diagnoses other than those defined by the CAPS goals from January 2000 to July 2023. The secondary outcome was the pooled proportion of final diagnoses matching the CAPS goals (PROSPERO: #CRD42022300408). Results: Twenty-three articles with 5,027 patients (median 109 patients/study, IQR 251) were included. The pooled prevalence of low-yield surgery was 2.1% [95%CI 0.9-3.7], I2 83%). In the subgroup analysis, this prevalence was non-significantly higher in studies that only included familial pancreatic cancer (FPC) subjects without known pathogenic variants (PV), compared to those enrolling PV carriers. No effect modifiers were found. Overall, the pooled prevalence of subjects under surveillance who had a pancreatic resection that contained target lesions was 0.8% [95%CI 0.3-1.5], I2 24%). The temporal analysis showed that the rate of low-yield surgeries decreased in the last decades and stabilized at around 1% (test for subgroup differences P<0.01). Conclusions: The risk of “low-yield” surgery during pancreatic cancer surveillance is relatively low but should be thoroughly discussed with individuals under surveillance.

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Recommendations for a More Organized and Effective Approach to the Early Detection of Pancreatic Cancer From the PRECEDE (Pancreatic Cancer Early Detection) Consortium

Cited by 24 publications

References 31 publications

Early Detection of Cancers in the Era of Precision Oncology

Early Detection of Cancers in the Era of Precision Oncology

Germline Aberrations in Pancreatic Cancer: Implications for Clinical Care

Surveillance of Individuals at High Risk of Developing Pancreatic Cancer

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