1145 Detection and Treatment of Pancreatic Cancer and High-Grade Precursor Lesions in High-Risk Individuals Undergoing Surveillance: Results From the International CAPS Consortium Registry

2016 ◽  
Vol 150 (4) ◽  
pp. S234
Author(s):  
Ingrid C. Konings ◽  
Jose A. Almario ◽  
Marcia I. Canto ◽  
Payal Saxena ◽  
Femme Harinck ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
High Risk ◽  
High Grade ◽  
Precursor Lesions

Prevalence and Progression of Pancreatic Cystic Precursor Lesions Differ Between Groups at High Risk of Developing Pancreatic Cancer

Pancreas ◽  
2017 ◽  
Vol 46 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Ingrid C. A. W. Konings ◽  
Femme Harinck ◽  
Jan-Werner Poley ◽  
Cora M. Aalfs ◽  
Anja van Rens ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
High Risk ◽  
Precursor Lesions

Variation in Precursor Lesions of Pancreatic Cancer among High-Risk Groups

2012 ◽  
Vol 19 (2) ◽  
pp. 442-449 ◽  
Author(s):  
Thomas P. Potjer ◽  
Ingrid Schot ◽  
Peter Langer ◽  
Johannes T. Heverhagen ◽  
Martin N.J.M. Wasser ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
High Risk ◽  
Risk Groups ◽  
Precursor Lesions

scholarly journals The Combination of MiRNA-196b, LCN2, and TIMP1 is a Potential Set of Circulating Biomarkers for Screening Individuals at Risk for Familial Pancreatic Cancer

2018 ◽  
Vol 7 (10) ◽  
pp. 295 ◽  
Author(s):  
Detlef Bartsch ◽  
Norman Gercke ◽  
Konstantin Strauch ◽  
Ronja Wieboldt ◽  
Elvira Matthäi ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
At Risk ◽  
Ductal Adenocarcinoma ◽  
Duodenal Juice ◽  
Familial Pancreatic Cancer ◽  
High Grade ◽  
Precursor Lesions ◽  
Kras Mutations ◽  
Specificity And Sensitivity ◽  
Serum Exosomes

Individuals at risk (IAR) of familial pancreatic cancer (FPC) are good candidates for screening. Unfortunately, neither reliable imaging modalities nor biomarkers are available to detect high-grade precursor lesions or early cancer. Circulating levels of candidate biomarkers LCN2, TIMP1, Glypican-1, RNU2-1f, and miRNA-196b were analyzed in 218 individuals with sporadic pancreatic ductal adenocarcinoma (PDAC, n = 50), FPC (n = 20), chronic pancreatitis (n = 10), IAR with relevant precursor lesions (n = 11) or non-relevant lesions (n = 5), 20 controls, and IAR with (n = 51) or without (n = 51) lesions on pancreatic imaging. In addition, corresponding duodenal juice samples were analyzed for Glypican-1 (n = 144) enrichment and KRAS mutations (n = 123). The panel miR-196b/LCN2/TIMP1 could distinguish high-grade lesions and stage I PDAC from controls with absolute specificity and sensitivity. In contrast, Glypican-1 enrichment in serum exosomes and duodenal juice was not diagnostic. KRAS mutations in duodenal juice were detected in 9 of 12 patients with PDAC and only 4 of 9 IAR with relevant precursor lesions. IAR with lesions on imaging had elevated miR-196b/LCN2/TIMP1 levels (p = 0.0007) and KRAS mutations in duodenal juice (p = 0.0004) significantly more often than IAR without imaging lesions. The combination miR-196b/LCN2/TIMP1 might be a promising biomarker set for the detection of high-grade PDAC precursor lesions in IAR of FPC families.

scholarly journals Management of patients with increased risk for familial pancreatic cancer: updated recommendations from the International Cancer of the Pancreas Screening (CAPS) Consortium

Gut ◽  
2019 ◽  
Vol 69 (1) ◽  
pp. 7-17 ◽  
Author(s):  
Michael Goggins ◽  
Kasper Alexander Overbeek ◽  
Randall Brand ◽  
Sapna Syngal ◽  
Marco Del Chiaro ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
High Risk ◽  
Multidisciplinary Teams ◽  
Familial Pancreatic Cancer ◽  
High Grade ◽  
Degree Relative ◽  
Delphi Approach ◽  
Cancer Of The Pancreas ◽  
Increased Risk ◽  
Consensus Statements

Background and aimThe International Cancer of the Pancreas Screening Consortium met in 2018 to update its consensus recommendations for the management of individuals with increased risk of pancreatic cancer based on family history or germline mutation status (high-risk individuals).MethodsA modified Delphi approach was employed to reach consensus among a multidisciplinary group of experts who voted on consensus statements. Consensus was considered reached if ≥75% agreed or disagreed.ResultsConsensus was reached on 55 statements. The main goals of surveillance (to identify high-grade dysplastic precursor lesions and T1N0M0 pancreatic cancer) remained unchanged. Experts agreed that for those with familial risk, surveillance should start no earlier than age 50 or 10 years earlier than the youngest relative with pancreatic cancer, but were split on whether to start at age 50 or 55. Germline ATM mutation carriers with one affected first-degree relative are now considered eligible for surveillance. Experts agreed that preferred surveillance tests are endoscopic ultrasound and MRI/magnetic retrograde cholangiopancreatography, but no consensus was reached on how to alternate these modalities. Annual surveillance is recommended in the absence of concerning lesions. Main areas of disagreement included if and how surveillance should be performed for hereditary pancreatitis, and the management of indeterminate lesions.ConclusionsPancreatic surveillance is recommended for selected high-risk individuals to detect early pancreatic cancer and its high-grade precursors, but should be performed in a research setting by multidisciplinary teams in centres with appropriate expertise. Until more evidence supporting these recommendations is available, the benefits, risks and costs of surveillance of pancreatic surveillance need additional evaluation.

A Critical Overview of Systematic Reviews of Chemotherapy for Advanced and Locally Advanced Pancreatic Cancer using both AMSTAR2 and ROBIS as Quality Assessment Tools

2020 ◽  
Vol 15 ◽  
Author(s):  
Amit Dang ◽  
Surendar Chidirala ◽  
Prashanth Veeranki ◽  
BN Vallish
Keyword(s):  
Pancreatic Cancer ◽  
High Risk ◽  
Systematic Reviews ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Risk Of Bias ◽  
Low Risk ◽  
Locally Advanced Pancreatic Cancer ◽  
Grade 3 ◽  
Critical Overview

Background: We performed a critical overview of published systematic reviews (SRs) of chemotherapy for advanced and locally advanced pancreatic cancer, and evaluated their quality using AMSTAR2 and ROBIS tools. Materials and Methods: PubMed and Cochrane Central Library were searched for SRs on 13th June 2020. SRs with metaanalysis which included only randomized controlled trials and that had assessed chemotherapy as one of the treatment arms were included. The outcome measures, which were looked into, were progression-free survival (PFS), overall survival (OS), and adverse events (AEs) of grade 3 or above. Two reviewers independently assessed all the SRs with both ROBIS and AMSTAR2. Results: Out of the 1,879 identified records, 26 SRs were included for the overview. Most SRs had concluded that gemcitabine-based combination regimes, prolonged OS and PFS, but increased the incidence of grade 3-4 toxicities, when compared to gemcitabine monotherapy, but survival benefits were not consistent when gemcitabine was combined with molecular targeted agents. As per ROBIS, 24/26 SRs had high risk of bias, with only 1/26 SR having low risk of bias. As per AMSTAR2, 25/26 SRs had critically low, and 1/26 SR had low, confidence in the results. The study which scored ‘low’ risk of bias in ROBIS scored ‘low confidence in results’ in AMSTAR2. The inter-rater reliability for scoring the overall confidence in the SRs with AMSTAR2 and the overall domain in ROBIS was substantial; ROBIS: kappa=0.785, SEM=0.207, p<0.001; AMSTAR2: kappa=0.649, SEM=0.323, p<0.001. Conclusion: Gemcitabine-based combination regimens can prolong OS and PFS but also worsen AEs when compared to gemcitabine monotherapy. The included SRs have an overall low methodological quality and high risk of bias as per AMSTAR2 and ROBIS respectively.

Possibility of detecting intraductal papillary mucinous neoplasms using metabolite biomarkers for pancreatic cancer

2020 ◽  
Vol 14 (11) ◽  
pp. 1009-1020
Author(s):  
Ryota Nakano ◽  
Shin Nishiumi ◽  
Takashi Kobayashi ◽  
Takuya Ikegawa ◽  
Yuzo Kodama ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
High Risk ◽  
Multiple Logistic Regression Analysis ◽  
High Sensitivity ◽  
Plasma Samples ◽  
Multiple Logistic Regression ◽  
Intraductal Papillary Mucinous Neoplasms ◽  
Detection Model ◽  
High Risk Factors ◽  
Mucinous Neoplasms

Aim: The aim of this study was to identify whether metabolite biomarker candidates for pancreatic cancer (PC) could aid detection of intraductal papillary mucinous neoplasms (IPMN), recognized as high-risk factors for PC. Materials & methods: The 12 metabolite biomarker candidates, which were found to be useful to detect PC in our previous study, were evaluated for plasma samples from patients with PC (n = 44) or IPMN (n = 24) or healthy volunteers (n = 46). Results: Regarding the performance of individual biomarkers of PC and PC high-risk IPMN, lysine exhibited the best performance (sensitivity: 67.8%; specificity: 86.9%). The multiple logistic regression analysis-based detection model displayed high sensitivity and specificity values of 92.5 and 90.6%, respectively. Conclusion: Metabolite biomarker candidates for PC are useful for detecting high-risk IPMN, which can progress to PC.

High-risk HPV-positive and -negative high-grade cervical dysplasia: Analysis of 5-year outcomes

2021 ◽  
Author(s):  
Giorgio Bogani ◽  
Francesco Sopracordevole ◽  
Violante Di Donato ◽  
Andrea Ciavattini ◽  
Alessandro Ghelardi ◽  
...  
Keyword(s):  
High Risk ◽  
Cervical Dysplasia ◽  
High Grade ◽  
High Risk Hpv
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