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The Role of Inherited Pathogenic CDKN2A Variants in Susceptibility to Pancreatic Cancer

Journal

PANCREAS
Volume 50, Issue 8, Pages 1123-1130

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MPA.0000000000001888

Keywords

pancreatic ductal adenocarcinoma; CDKN2A; genetics; inherited; screening; therapy

Funding

  1. Sol Goldman Pancreatic Cancer Research Center
  2. Susan Wojcicki and Denis Troper
  3. Rolfe Pancreatic Cancer Foundation
  4. National Institutes of Health, National Cancer Institute [P50 CA62924, R00 CA190889]
  5. Japanese Society of Gastroenterology Support for Young Gastroenterologists Studying in the United States
  6. Joseph C Monastra Foundation
  7. Art Creates Cures Foundation

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CDKN2A plays a crucial role in the development of pancreatic cancer, with carriers of pathogenic germline variants having an increased risk of the disease.
CDKN2A is cell cycle negative regulator, and the role of CDKN2A in the development of pancreatic ductal adenocarcinoma, which continues to be a lethal cancer, is well-established. Somatic loss of CDKN2A is considered one of the major drivers of pancreatic tumorigenesis. CDKN2A gene is one of the pancreatic cancer susceptibility gene; in addition to melanoma, pathogenic germline CDKN2A variants have been identified in up to 3.3% patients with pancreatic ductal adenocarcinoma depending on family history of disease. Carriers of a known pathogenic germline CDKN2A variant have up to a 12.3-fold increased risk of developing pancreatic cancer. Recently, several studies have demonstrated the benefit of clinical surveillance in patients with pathogenic germline CDKN2A variants. Therefore, identification of patients with a pathogenic germline CDKN2A variant is important for screening of at-risk relatives for pancreatic cancer. It has the potential to lead to the detection of early, potentially curable pancreatic cancer and precursor neoplasms, and reduce mortality. Furthermore, patients with a germline pathogenic CDKN2A variant and somatic loss of CDKN2A may benefit in the future from treatment with targeted therapies, such as a CDK4/6 inhibitor.

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