Title |
Real-time genomic characterization of advanced pancreatic cancer to enable precision medicine
|
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Published in |
Cancer Discovery, September 2018
|
DOI | 10.1158/2159-8290.cd-18-0275 |
Pubmed ID | |
Authors |
Andrew J Aguirre, Jonathan A Nowak, Nicholas D Camarda, Richard A Moffitt, Arezou A Ghazani, Mehlika Hazar-Rethinam, Srivatsan Raghavan, Jaegil Kim, Lauren K Brais, Dorisanne Ragon, Marisa W Welch, Emma Reilly, Devin McCabe, Lori Marini, Kristin Anderka, Karla Helvie, Nelly Oliver, Ana Babic, Annacarolina Da Silva, Brandon Nadres, Emily E Van Seventer, Heather A Shahzade, Joseph P St Pierre, Kelly P Burke, Thomas Clancy, James M Cleary, Leona A Doyle, Kunal Jajoo, Nadine J McCleary, Jeffrey A Meyerhardt, Janet E Murphy, Kimmie Ng, Anuj K Patel, Kimberly Perez, Michael H Rosenthal, Douglas A Rubinson, Marvin Ryou, Geoffrey I Shapiro, Ewa Sicinska, Stuart G Silverman, Rebecca J Nagy, Richard B Lanman, Deborah Knoerzer, Dean J Welsch, Matthew B Yurgelun, Charles S Fuchs, Levi A Garraway, Gad Getz, Jason L Hornick, Bruce E Johnson, Matthew H Kulke, Robert J Mayer, Jeffrey W Miller, Paul B Shyn, David A Tuveson, Nikhil Wagle, Jen Jen Yeh, William C Hahn, Ryan B Corcoran, Scott L Carter, Brian M Wolpin |
Abstract |
Clinically relevant subtypes exist for pancreatic ductal adenocarcinoma (PDAC), but molecular characterization is not yet standard in clinical care. We implemented a biopsy protocol to perform time-sensitive whole exome sequencing and RNA-sequencing for patients with advanced PDAC. Therapeutically relevant genomic alterations were identified in 48% (34/71) and pathogenic/likely pathogenic germline alterations in 18% (13/71) of patients. Overall, 30% (21/71) of enrolled patients experienced a change in clinical management as a result of genomic data. Twenty-six patients had germline and/or somatic alterations in DNA-damage repair genes, and 5 additional patients had mutational signatures of homologous recombination deficiency but no identified causal genomic alteration. Two patients had oncogenic in-frame BRAF deletions, and we report the first clinical evidence that this alteration confers sensitivity to MAP-kinase pathway inhibition. Moreover, we identified tumor/stroma gene expression signatures with clinical relevance. Collectively, these data demonstrate the feasibility and value of real-time genomic characterization of advanced PDAC. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 38 | 38% |
France | 3 | 3% |
Australia | 3 | 3% |
India | 3 | 3% |
Spain | 3 | 3% |
United Kingdom | 3 | 3% |
Argentina | 2 | 2% |
Mexico | 2 | 2% |
Turkey | 2 | 2% |
Other | 9 | 9% |
Unknown | 33 | 33% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 54 | 53% |
Scientists | 30 | 30% |
Practitioners (doctors, other healthcare professionals) | 14 | 14% |
Science communicators (journalists, bloggers, editors) | 2 | 2% |
Unknown | 1 | <1% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 268 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 51 | 19% |
Student > Ph. D. Student | 47 | 18% |
Other | 21 | 8% |
Student > Bachelor | 18 | 7% |
Student > Master | 15 | 6% |
Other | 37 | 14% |
Unknown | 79 | 29% |
Readers by discipline | Count | As % |
---|---|---|
Biochemistry, Genetics and Molecular Biology | 63 | 24% |
Medicine and Dentistry | 60 | 22% |
Agricultural and Biological Sciences | 26 | 10% |
Immunology and Microbiology | 6 | 2% |
Pharmacology, Toxicology and Pharmaceutical Science | 4 | 1% |
Other | 19 | 7% |
Unknown | 90 | 34% |