Comprehensive analysis of DNA damage repair genes reveals pathogenic variants beyond BRCA and suggests the need for extensive genetic testing in pancreatic cancer

BMC Cancer. 2021 May 26;21(1):611. doi: 10.1186/s12885-021-08368-5.

Abstract

Background: Pancreatic cancer (PC) is a major cause of cancer death. In an effort to improve treatment strategies and outcomes, DNA damage repair (DDR) pathways have been introduced as a new target in PC and in other cancers, through the exploitation of synthetic lethality. Furthermore, genes involved in DDR are among the major determinants of cancer susceptibility. In addition to the well-known BRCA1 and BRCA2 genes, a plethora of other targets in the same pathways are now emerging.

Methods: We analyzed samples from 60 patients, affected by PC and already tested for BRCA, using a panel with 24 other cancer susceptibility genes.

Results: We detected 8 pathogenic or likely pathogenic mutations (13.3% of samples analyzed), 4 of which were found in non-BRCA genes (2 in ATM, 1 each in PALB2 and RAD50). Furthermore, 4 pathogenic or likely pathogenic mutations were found in patients without a personal or familial history of cancer.

Conclusions: Our results suggest that genetic testing with a comprehensive gene panel should be perfomed in all patients with PC, in order to allow screening for PC and other gene-related cancers in all at risk family members and to assess patients' eligibility for emerging therapeutic options.

Keywords: Cancer susceptibility; DNA damage repair; Gene panel; Pancreatic cancer; Targeted therapy.

Publication types

  • Observational Study

MeSH terms

  • Acid Anhydride Hydrolases / genetics
  • Adult
  • Aged
  • Aged, 80 and over
  • Ataxia Telangiectasia Mutated Proteins / genetics
  • BRCA1 Protein / genetics
  • BRCA2 Protein / genetics
  • Biomarkers, Tumor / genetics*
  • DNA Damage
  • DNA Mutational Analysis / statistics & numerical data
  • DNA Repair*
  • DNA-Binding Proteins / genetics
  • Early Detection of Cancer / methods*
  • Early Detection of Cancer / statistics & numerical data
  • Fanconi Anemia Complementation Group N Protein / genetics
  • Female
  • Genetic Testing / methods*
  • Genetic Testing / statistics & numerical data
  • Humans
  • Male
  • Medical History Taking
  • Middle Aged
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / genetics

Substances

  • BRCA1 Protein
  • BRCA1 protein, human
  • BRCA2 Protein
  • BRCA2 protein, human
  • Biomarkers, Tumor
  • DNA-Binding Proteins
  • Fanconi Anemia Complementation Group N Protein
  • PALB2 protein, human
  • ATM protein, human
  • Ataxia Telangiectasia Mutated Proteins
  • Acid Anhydride Hydrolases
  • RAD50 protein, human