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ATM Mutations in Patients with Hereditary Pancreatic Cancer
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Abstract
Pancreatic cancers are the fourth most-common cause of cancer-related deaths in the Western world, with >200,000 cases reported in 2010. Although up to 10% of these cases occur in familial patterns, the hereditary basis for predisposition in the vast majority of affected families is unknown. We used next-generation sequencing, including whole-genome and whole-exome analyses, and identified heterozygous, constitutional, ataxia telangiectasia mutated (ATM) gene mutations in 2 kindreds with familial pancreatic cancer. Mutations segregated with disease in both kindreds and tumor analysis demonstrated LOH of the wild-type allele. By using sequence analysis of an additional 166 familial pancreatic cancer probands, we identified 4 additional patients with deleterious mutations in the ATM gene, whereas we identified no deleterious mutations in 190 spouse controls (P = 0.046). When we considered only the mostly severely affected families with 3 or more pancreatic cancer cases, 4 deleterious mutations were found in 87 families (P = 0.009). Our results indicate that inherited ATM mutations play an important role in familial pancreatic cancer predisposition. Significance: The genes responsible for the majority of cases of familial pancreatic ductal adenocarcinoma are unknown. We here identify ATM as a predisposition gene for pancreatic ductal adenocarcinoma. Our results have important implications for the management of patients in affected families and illustrate the power of genome-wide sequencing to identify the basis of familial cancer syndromes. Cancer Discovery; 2(1): 41–6. ©2011 AACR. Read the Commentary on this article by Bakker and de Winter, p. 14 This article is highlighted in the In This Issue feature, p. 1
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“Pancreatic surveillance is recommended for carriers of germline deleterious variants in cancer susceptibility gene,22–26: BRCA2, ATM, BRCA1, PALB2, CDKN2A, STK11, MLH1 and MSH2.”
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“Most recently, germline mutations in ATM (encoding the protein kinase Ataxia telangiectasia mutated) have been described in subsets of familial pancreatic cancer families [40].”
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“Panel recommendations Although there is evidence that pancreatic cancer risk is moderately increased (~ 5% lifetime) in ATM carriers, there are currently no NCCN guidelines for pancreatic cancer screening in ATM carriers [32].”
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“ATM (gene product mutated in human genetic disorder ataxia telangiectasia) is one of the most commonly mutated DDR genes which is sporadically mutated in familial pancreatic cancer (63).”
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“Inherited deleterious ATM mutations have been associated with both breast cancer and pancreatic cancer predisposition [22, 23].”
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“However, new and different germline mutations, including PALB2 and ATM [23, 24], have been recently identified.”
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“Some of them correspond to known syndromes with germline mutations in genes associated with cancer predisposition syndromes, such as BRCA2 [78], PALB2 [79] and ATM [80] (Table 3).”
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“…KRAS, CHEK2, BARD1, BRCA1, and BRCA2 [57], the DNA mismatch repair (MMR) genes MLH1, MSH2, MSH6, and PMS2 [58], and CDKN2A, NBN, SMAD4, ATM [59], PALB2 [60] STK11 [61], TP53, and MUTYH/MYH [62] are some of the genes associated with PC. Based on genomic analysis, KRAS, CHEK2, BARD1, BRCA1,…”
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“Recent evidence has shown the advisability and efficiency of rare predisposition gene identification by study of extended pedigrees (Ewing et al., 2012; Roberts et al., 2012).”
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“ATM is mutated in some hereditary forms of pancreatic cancer (Grant et al. 2014; Roberts et al. 2012) as well as ~ 6% of sporadic pancreatic adenocarcinoma, with 4% of overall mutations resulting in deletion of the ATM protein (Kim et al.”
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Self-citationRs488087 single nucleotide polymorphism as predictive risk factor for pancreatic cancers
Martinez, E., Silvy, F., Fina, F., Bartoli, M., Krahn, M., Barlési, F., Figarella‐Branger, D., Iovanna, J., Laugier, R., Ouaïssi, M., et al. (2015) · Oncotarget · doi:10.18632/oncotarget.5627 · Cited by 13
“BCRA1 and the ataxia telangiectasia (ATM) gene were also mutated in patients with hereditary PC [21, 22].”
BackgroundPantaleo, A., Forte, G., Fasano, C., Signorile, M. L., Sanese, P., Marco, K. D., Nicola, E. D., Latrofa, M., Grossi, V., Disciglio, V., et al. (2023) · Cancers · doi:10.3390/cancers16010056 · Cited by 15
“Importantly, monoallelic ATM germline alterations have also been reported in familial and sporadic cases of PDAC [67].”
BackgroundATM is required for the repair of Topotecan-induced replication-associated double-strand breaks
Köcher, S., Spies-Naumann, A., Kriegs, M., Dahm‐Daphi, J., & Dornreiter, I. (2013) · Radiotherapy and Oncology · doi:10.1016/j.radonc.2013.06.024 · Cited by 14
Jiao, Y., Lumpkins, K. M., Terhune, J. H., Hruban, R. H., Klein, A. P., Kinzler, K. W., Papadopoulos, N., Vogelstein, B., & Strauch, E. D. (2014) · Pancreatology · doi:10.1016/j.pan.2014.10.009 · Cited by 13
Self-citationScreening of Patients at Risk for Familial Pancreatic Cancer
Torphy, R. J., & Schulick, R. D. (2017) · Surgical Clinics of North America · doi:10.1016/j.suc.2017.09.003 · Cited by 13
Self-citationCombinations of Low-Frequency Genetic Variants Might Predispose to Familial Pancreatic Cancer
Slater, E. P., Wilke, L. M., Böhm, L. B., Strauch, K., Lutz, M., Krasser‐Gercke, N., Matthäi, E., Hemminki, K., Försti, A., Schlesner, M., et al. (2021) · Journal of Personalized Medicine · doi:10.3390/jpm11070631 · Cited by 14
“This prevalence lies within the reported range, between 2.2% (4/166) [31] and 5% (4/81) [32], from previous studies on FPC.”
InfluentialLi, X., O’Neil, N. J., Moshgabadi, N., & Hieter, P. (2014) · Genetics · doi:10.1534/genetics.114.161307 · Cited by 13
“…a frequency of 1/40,000, up to 1% of the population could be heterozygous carriers of ATM mutations, and these carrier individuals are estimated to have an increased risk of pancreatic cancer and breast cancer (Savitsky et al. 1995; Thompson et al. 2005; Renwick et al. 2006; Roberts et al. 2012).”
BackgroundEpidemiology of Pancreatic Cancer
Mocci, E., & Klein, A. P. (2018) · doi:10.1002/9781119188421.ch88 · Cited by 14
Self-citationChen, X., Meyer, M. A., Kemppainen, J. L., Horibe, M., Chandra, S., Majumder, S., Petersen, G. M., & Rabe, K. G. (2023) · JAMA Oncology · doi:10.1001/jamaoncol.2023.0806 · Cited by 14
Self-citationMatsubayashi, H., Kiyozumi, Y., Ishiwatari, H., Uesaka, K., Kikuyama, M., & Ono, H. (2019) · Diagnostics · doi:10.3390/diagnostics9040169 · Cited by 12
“Recently, variants of genes functioning in the homologous recombination (HR) pathway have been considered not only in terms of surveillance, but also as they relate to treatments [41]: ATM (variant rate: 2–4%) [42,43], BRCA1 (0–7%) [44,45], BRCA2 (4–17%) [15,43,46], CHEK2 (1–6%) [47], PALB2 (1–4%) [43,48,49], and RAD5…”
BackgroundJabbour, T. E., Misyura, M., Cowzer, D., Zimmermann, M., Rimkunas, V. M., Marra, A., Derakhshan, F. N., Selenica, P., Parilla, M., Setton, J. S., et al. (2022) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djac024 · Cited by 13
Kamphues, C., Bova, R., Bahra, M., Klauschen, F., Muckenhuber, A., Sinn, B. V., Warth, A., Goeppert, B. F., Endris, V., Neuhaus, P., et al. (2014) · Pancreas · doi:10.1097/mpa.0000000000000248 · Cited by 12
“The fact that loss of ATM function plays a pivotal role in PDAC tumor progression is underscored by a very recent report that showed deleterious germline mutations in the ATM gene as well as a case with an ATM-double hit by the occurrence of LOH.(14,15) Moreover, Biankin and colleagues(13) reported ATM aberrations (LO…”
BackgroundScreening guidelines and recommendations for patients at high risk of developing endocrine cancers
Geurts, J. L., Strong, E. A., Wang, T. S., Evans, D. B., & Clarke, C. N. (2020) · Journal of Surgical Oncology · doi:10.1002/jso.25869 · Cited by 12
“Heterozygotes also carry an attenuated increased risk of developing breast cancers and PDAC largely due to loss of heterozygosity.(54,55) Lynch syndrome is an autosomal dominant syndrome that results from mutations in DNA mismatch repair genes and is associated with the development of colorectal cancer.”
BackgroundEstablishing a Clinic-Based Pancreatic Cancer and Periampullary Tumour Research Registry in Quebec
Smith, A. L., Bascuñana, C., Hall, A., Salman, A., Andrei, A.-Z., Volenik, A., Rothenmund, H., Ferland, D., Lamoussenery, D., Kamath, A. S., et al. (2015) · Current Oncology · doi:10.3747/co.22.2300 · Cited by 12
Self-citationA Role for ATM in Hereditary Pancreatic Cancer
Bakker, J. L., & de Winter, J. P. (2012) · Cancer Discovery · doi:10.1158/2159-8290.cd-11-0318 · Cited by 11
“The study by Roberts and colleagues (3) now adds ATM to this list of genes involved in both breast and pancreatic cancer.”
BackgroundMethodInfluentialScreening for Pancreatic Cancer in High-risk Populations
Grover, S., & Jajoo, K. (2016) · Gastroenterology Clinics of North America · doi:10.1016/j.gtc.2015.10.001 · Cited by 11
Prédisposition héréditaire au cancer du sein (1)
Cohen‐Haguenauer, O. (2019) · médecine/sciences · doi:10.1051/medsci/2019003 · Cited by 12
Candido, S., Abrams, S. L., Steelman, L. S., Lertpiriyapong, K., Martelli, A. M., Cocco, L., Ratti, S., Follo, M. Y., Murata, R. M., Rosalen, P. L., et al. (2019) · Advances in Biological Regulation · doi:10.1016/j.jbior.2019.03.002 · Cited by 11
Weng, C., Lin, Y., & Cheng, K. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8091369 · Cited by 12
Molecular and Genetic Basis of Pancreatic Carcinogenesis
Bernard, V., Fleming, J. B., & Maitra, A. (2016) · Surgical Oncology Clinics of North America · doi:10.1016/j.soc.2015.11.003 · Cited by 13
Prodosmo, A., Buffone, A., Mattioni, M., Barnabei, A., Persichetti, A., Leo, A. D., Appetecchia, M., Nicolussi, A., Coppa, A., Sciacchitano, S., et al. (2016) · Journal of Experimental & Clinical Cancer Research · doi:10.1186/s13046-016-0410-3 · Cited by 11
“Besides early onset-breast cancer, ATM carriers have been reported to be more susceptible to other types of cancer, such as digestive tract, lung, and thyroid cancers [2, 8].”
Klein, A. P. (2023) · Wiley eBooks · doi:10.1002/9781119876007.ch124 · Cited by 11
Self-citationMaxwell, K. N., & Domchek, S. M. (2013) · Current Breast Cancer Reports · doi:10.1007/s12609-013-0117-9 · Cited by 10
“6 %) of familial pancreatic cancer families were found to have ATM mutations [124].”
Wang, S., Zheng, Y., Ogundiran, T. O., Ojengbede, O. A., Zheng, W., Nathanson, K. L., Nemesure, B. B., Ambs, S., Olopade, O. I., & Huo, D. (2017) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-17-0755 · Cited by 10
Katona, B. W., Long, J. M., Ahmad, N. A., Attalla, S., Bradbury, A. R., Carpenter, E. L., Clark, D. F., Constantino, G., Das, K. K., Domchek, S. M., et al. (2021) · Cancer Prevention Research · doi:10.1158/1940-6207.capr-21-0161 · Cited by 10
Mechanisms of Gastrointestinal Malignancies
Katona, B. W., & Lynch, J. P. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-809954-4.00066-9 · Cited by 11
Martín-Rodríguez, S., Calvo‐Ferrer, A., Ortega‐Unanue, N., Samaniego‐Jimenez, L., Sanz‐Izquierdo, M., & Bernardo, I. (2019) · Annals of Human Genetics · doi:10.1111/ahg.12312 · Cited by 10
“…carriers: although ATM mutation carriers do not present A-T phenotype, they have increased risk of developing malignancies, particularly breast cancer (Buys et al., 2017), leukemia (Bullrich et al., 1999), lymphoma (Oguchi, Takagi, & Tsichida, 2003), and pancreatic cancer (Roberts et al., 2012).”
BackgroundPancreatic Cancer Surveillance: Who, When, and How
Dudley, B., & Brand, R. E. (2019) · Current Treatment Options in Gastroenterology · doi:10.1007/s11938-019-00247-0 · Cited by 12
DNA damage response and repair in pancreatic cancer development and therapy
Farnood, P. R., Pazhooh, R. D., Asemi, Z., & Yousefi, B. (2021) · DNA repair · doi:10.1016/j.dnarep.2021.103116 · Cited by 11
Pancreatic Cancer Surveillance and Novel Strategies for Screening
Dudley, B., & Brand, R. E. (2021) · Gastrointestinal Endoscopy Clinics of North America · doi:10.1016/j.giec.2021.08.008 · Cited by 10
Pancreatic Cancer Genomes: Toward Molecular Subtyping and Novel Approaches to Diagnosis and Therapy
Wood, L. D. (2013) · Molecular Diagnosis & Therapy · doi:10.1007/s40291-013-0043-6 · Cited by 10
Germline testing for homologous recombination repair genes—opportunities and challenges
Hirsch, S., Gieldon, L., Sutter, C., Dikow, N., & Schaaf, C. P. (2020) · Genes Chromosomes and Cancer · doi:10.1002/gcc.22900 · Cited by 12
“6%; ATM 2,4%).(41,42) Due to limited treatment options and the poor outcome for pancreatic ductal adenocarcinoma, many centers now consider germline testing of HRR genes for all patients in order to identify those who might benefit from the use of PARP inhibition as an additional treatment option.”
Background
Metadata
- Authors
- Roberts, N. J., Jiao, Y., Yu, J., Kopelovich, L., Petersen, G. M., Bondy, M. L., Gallinger, S., Schwartz, A. G., Syngal, S., Cote, M. L., Axilbund, J., Schulick, R., Ali, S. Z., Eshleman, J. R., Velculescu, V. E., Goggins, M., Vogelstein, B., Papadopoulos, N., Hruban, R. H., Kinzler, K. W., & Klein, A. P.
- Affiliations
- Brigham and Women's Hospital (US)
- Authors' Affiliations: 1Ludwig Center for Cancer Genetics and Howard Hughes Medical Institutions, Johns Hopkins Kimmel Cancer Center; Departments of 2Medicine, 3Pathology, 4Surgery, and 5Oncology, Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins Medical Institutions; 6Department of Epidemiology, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland; 7Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland; 8Division of Epidemiology, Mayo Clinic, Rochester, Minnesota; 9Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas; 10Hepatobiliary/Pancreatic Surgical Oncology Program, University Health Network, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada; 11Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, Michigan; 12Population Sciences Division, Dana-Farber Cancer Institute, and Gastroenterology Division, Brigham and Women's Hospital, Boston, Massachusetts
- Mayo Clinic (US)
- Corresponding author
- Hruban, Ralph H.
- Kinzler, Kenneth W.
- Klein, Alison P.
- ORCID
- Venue
- Cancer Discovery
- Published
- 2012-01-01
- Volume
- 2
- Issue
- 1
- Pages
- 41-46
- ISSN
- 2159-8274 (ISSN-L)
- 2159-8290
- PMC
- PMC3676748
- OpenAlex
- W2146542392
- Cited by
- 491
- References
- 30
- Citations by year
- 2026: 13 · 2025: 11 · 2024: 22 · 2023: 27 · 2022: 30 · 2021: 49 · 2020: 36 · 2019: 43 · 2018: 42 · 2017: 38 · 2016: 49 · 2015: 41 · 2014: 38 · 2013: 31 · 2012: 20
- FWCI
- 14.03
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Cancer Discovery (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01pc35145-19-0-7, n01cn43302-6-0-1, 5r01ca121113-15)
- National Cancer Institute (N01 CN043302, R01CA-97075, CA123483, R01CA123483, R01-CA121113, N01 PC035145, CA-121113, N01 PC 35145, CA057345, P50CA102701, R01CA057345, R01CA097075, N01-CN 43302, P50CA062924, R37CA057345, CA 62924)
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Genetic factors in colorectal cancer
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
- Keywords
- ATM gene, hereditary pancreatic cancer, pancreatic ductal adenocarcinoma, hereditary cancer predisposition, loss of heterozygosity, constitutional mutation, cancer susceptibility genes, hereditary cancer
- MeSH terms
- Ataxia Telangiectasia, DNA-Binding Proteins, Humans, Mutation, Pancreatic Neoplasms, Pedigree, Protein Serine-Threonine Kinases, Cell Cycle Proteins, Genetic Predisposition to Disease, Carcinoma, Pancreatic Ductal, Tumor Suppressor Proteins, Genome-Wide Association Study, Exome, Ataxia Telangiectasia Mutated Proteins
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