title: Pancreatic ductal adenocarcinoma in BRCA2 mutation carriers.
abstract: Germline BRCA2 mutations are the first known cause of inherited (familial) pancreatic ductal adenocarcinoma (PDAC). This tumor is the third most frequent cancer in carriers of germline BRCA2 mutations, as it occurs in around 10% of BRCA2 families. PDAC is known as one of the most highly lethal cancers, mainly because of its chemoresistance and frequently late diagnosis. Based on recent developments in molecular biology, a subgroup of BRCA2-associated PDAC has been created, allowing screening, early surgical treatment and personalized systemic treatment. BRCA2 germline mutation carriers who have ≥1 first-degree relative, or ≥2 blood relatives with PDAC, should undergo screening and regular follow-up based on magnetic resonance imaging and endoscopic ultrasound. The goal of screening is to detect early invasive PDAC and advanced precancerous lesions suitable for a stepwise surgical complete (R0) resection. Increasing evidence on the molecular role of the BRCA2 protein in the homologous recombination of DNA damages suggest that BRCA2-related PDAC are sensitive to agents causing DNA cross-linking damage, such as platinum salts, and treatments targeting rescue DNA repair pathways, such as poly(ADP-ribose) polymerase inhibitors that are currently under investigation.
authors: Department of Gastroenterology and PancreatologyBeaujon Hospital, Paris 7 University, APHP, Clichy, France.
authors: Louis
authors: L
authors: de Mestier
authors: Department of Hepato-GastroenterologyEuropean Georges-Pompidou Hospital, APHP, Paris, France.
authors: Jean-Baptiste
authors: JB
authors: Danset
authors: Department of Digestive OncologyBeaujon Hospital, Paris 7 University, APHP, Clichy, France.
authors: Cindy
authors: C
authors: Neuzillet
authors: Department of Gastroenterology and PancreatologyBeaujon Hospital, Paris 7 University, APHP, Clichy, France.
authors: Vinciane
authors: V
authors: Rebours
authors: Department of PathologyBeaujon Hospital, Paris 7 University, APHP, Clichy, France.
authors: Jérôme
authors: J
authors: Cros
authors: Department of GeneticsBichat Hospital, Paris 7 University, APHP, Clichy, France.
authors: Nadem
authors: N
authors: Soufir
authors: Department of Digestive OncologyBeaujon Hospital, Paris 7 University, APHP, Clichy, France pascal.hammel@aphp.fr.
authors: Pascal
authors: P
authors: Hammel
mesh_terms: D024682:BRCA2 Protein / Q000235:genetics*; D021441:Carcinoma, Pancreatic Ductal / Q000235:genetics*; D020022:Genetic Predisposition to Disease; D018095:Germ-Line Mutation; D006579:Heterozygote; D006801:Humans; D010190:Pancreatic Neoplasms / Q000235:genetics*
chemical_list: D024682:BRCA2 Protein; C551750:BRCA2 protein, human
keywords: BRCA2; PARP inhibitors; pancreatic cancer; screening; treatment