دورية أكاديمية
Clinical and molecular characteristics of patients with brain metastasis secondary to pancreatic ductal adenocarcinoma.
| العنوان: | Clinical and molecular characteristics of patients with brain metastasis secondary to pancreatic ductal adenocarcinoma. |
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| المؤلفون: | Yousef M; Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Hurd MW; Sheikh Ahmed Center for Pancreatic Cancer Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Yousef A; Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Ludmir EB; Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Pillai AB; Department of Hospital Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Peterson J; Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Koay EJ; Department of Gastrointestinal Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Albarouki S; Department of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, United States., Tzeng CW; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Snyder R; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Katz MHG; Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Wang H; Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Overman MJ; Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Maitra A; Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Pant S; Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Smaglo BG; Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Wolff RA; Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Yao J; Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Shen JP; Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States., Zhao D; Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States. |
| المصدر: | The oncologist [Oncologist] 2024 Jul 16. Date of Electronic Publication: 2024 Jul 16. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Oxford University Press Country of Publication: England NLM ID: 9607837 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1549-490X (Electronic) Linking ISSN: 10837159 NLM ISO Abbreviation: Oncologist Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2022- : Oxford : Oxford University Press Original Publication: Dayton, Ohio : AlphaMed Press, c1996- |
| مستخلص: | Background: The prognosis for patients with pancreatic ductal adenocarcinoma (PDAC) is poor. Secondary brain metastasis (Br-M) occurs in less than 1% of patients. Clinical characteristics and molecular alterations have not been characterized in this rare patients' subset. Materials and Methods: The Foundry software platform was used to retrospectively query electronic health records for patients with Br-M secondary to PDAC from 2005 to 2023; clinical, molecular, and overall survival (OS) data were analyzed. Results: Br-M was diagnosed in 44 patients with PDAC. Median follow-up was 78 months; median OS from initial PDAC diagnosis was 47 months. Median duration from PDAC diagnosis to Br-M detection was 24 months; median OS from Br-M diagnosis was 3 months. At Br-M diagnosis, 82% (n = 36) of patients had elevated CA19-9. Lung was the most common preexisting metastatic location (71%) with Br-M, followed by liver (66%). Br-M were most frequently observed in the frontal lobe (34%, n = 15), cerebellar region (23%, n = 10), and leptomeninges (18%, n = 8). KRAS mutations were detected in 94.1% (n = 16) of patients who had molecular data available (n = 17) with KRASG12V being the most frequent subtype 47% (n = 8); KRASG12D in 29% (n = 5); KRASG12R in 18% (n = 3). Patients who underwent Br-M surgical resection (n = 5) had median OS of 8.6 months, while median OS following stereotactic radiosurgery only (n = 11) or whole-brain radiation only (n = 20) was 3.3 and 2.8 months, respectively. Conclusion: Br-M is a late PDAC complication, resulting in an extremely poor prognosis especially in leptomeningeal disease. KRAS was mutated in 94.1% of the patients and the KRASG12V subtype was prevalent. (© The Author(s) 2024. Published by Oxford University Press.) |
| معلومات مُعتمدة: | Col. Daniel Connelly Memorial Fund; K22 CA234406 United States CA NCI NIH HHS |
| فهرسة مساهمة: | Keywords: KRAS; PDAC; brain metastases; genetic testing; mutation; pancreatic cancer |
| تواريخ الأحداث: | Date Created: 20240717 Latest Revision: 20240717 |
| رمز التحديث: | 20240717 |
| DOI: | 10.1093/oncolo/oyae182 |
| PMID: | 39014543 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1549-490X |
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| DOI: | 10.1093/oncolo/oyae182 |