4 - Results of First Round of Enrollment from the Screening for Pancreatic Cancer in High-Risk Individuals (Pancreas Scan Study): A Prospective Multi-Center Study

Award: Outstanding Research Award in the Biliary/Pancreas Category (Trainee)

Ishani Shah, MD¹, Andy Silva-Santisteban, MD¹, Katharine A. Germansky, MD¹, Rishi Pawa, MBBS², Vladimir Kushnir, MD³, Arvind Trindade, MD⁴, Jiannis Anastasiou, MD⁵, Kara L. Raphael, MD⁶, Girish Mishra, MD², Sumant Inamdar, MD⁵, Benjamin Tharian, MD⁵, Mandeep S. Sawhney, MD^1
1Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; ²Atrium Health Wake Forest Baptist, Winston-Salem, NC; ³Washington University School of Medicine, St. Louis, MO; ⁴Zucker School of Medicine at Hofstra/Northwell, Long-Island Jewish Hospital, Great Neck, NY; ⁵University of Arkansas for Medical Sciences, Little Rock, AR; ⁶Zucker School of Medicine at Hofstra/Northwell, Northwell Health, North Shore University Hospital, Great Neck, NY

Introduction: Multiple guidelines endorse pancreas cancer screening in genetically susceptible individuals. However, data on outcomes of screening are limited. Our goal was to conduct a prospective, multicenter study to evaluate yield, harms, and outcomes of pancreas cancer screening.

Methods: All high-risk individuals undergoing EUS or MRCP for pancreas cancer screening at 5 institutions in the US from 2020 to 2022 were prospectively enrolled. Pancreas pathology was designated as low-risk (fatty pancreas or chronic pancreatitis-like changes), intermediate-risk (neuroendocrine tumor (NET) < 2cm or branch duct IPMN) and high-risk (High grade PanIN/dysplasia, main duct IPMN, NET >2cm, or pancreatic cancer). Harms from screening included: 1) adverse events during screening EUS or MRI, or 2) undergoing low-yield pancreatic surgery (where pathology did not show high-grade dysplasia or cancer). (ClinicalTrials.gov: NCT05006131)

Results: During study period, 252 patients undergoing pancreas cancer screening (EUS in 208 and MRCP in 44 patients) were enrolled, of which 97 underwent their first screening. Mean age was 59.9 years, 69% were female and 79.4% were White. Indication was familial pancreatic cancer syndrome (31.7%), BRCA2 (29%), BRCA1 (7.5%), ATM (3.5%), Lynch syndrome (6.7%), Peutz-Jeghers (4.3%), and FAMMM (3.5%). Remaining 13% did not meet current guideline screening criteria.

Low-risk pancreas pathology was noted in 23.4%, intermediate risk in 31.7%, and high risk in 0.8% of patients (Table 1). In all, tissue sampling was performed for 5 solid pancreatic lesions, 12 pancreatic cystic lesions, 1 abnormal duct, and 1 lymph node.

Two patients had pancreatic cancer, including 1 patient with T2N1M0 (stg IIB) cancer, who underwent neoadjuvant treatment and pancreatic resection. The second patient had T2N1M1 (stg IV) cancer and underwent palliative chemotherapy.

Twelve (4.8%) patients underwent further pancreatic evaluation due to screening findings (EUS in 8 patients and an MRCP in 4 patients). None of the patients underwent low-yield pancreatic surgery. There were no adverse events from screening tests or from further interventions.

Discussion: Pancreas cancer screening in high-risk individuals detected intermediate-risk lesions in 32% and high-risk lesions in 0.8% patients. Screening did not lead to any harms. Resection with curative intent was performed in 1 of 2 patients with pancreatic cancer.



Disclosures:


Ishani Shah, MD¹, Andy Silva-Santisteban, MD¹, Katharine A. Germansky, MD¹, Rishi Pawa, MBBS², Vladimir Kushnir, MD³, Arvind Trindade, MD⁴, Jiannis Anastasiou, MD⁵, Kara L. Raphael, MD⁶, Girish Mishra, MD², Sumant Inamdar, MD⁵, Benjamin Tharian, MD⁵, Mandeep S. Sawhney, MD¹, 4, Results of First Round of Enrollment from the Screening for Pancreatic Cancer in High-Risk Individuals (Pancreas Scan Study): A Prospective Multi-Center Study, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.