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Principal Investigator: Mary Linton B Peters
Organization: BETH ISRAEL DEACONESS MEDICAL CENTER
Fiscal Year: 2024
Award: $252,164
Funding agency: National Cancer Institute
Project Summary
Recent evidence suggests that up to 10% of patients with Pancreatic Ductal AdenoCarcinoma (PDAC) harbor
a germline genetic mutation in a cancer risk gene. For this reason, the National Comprehensive Cancer
Network (NCCN) and American Society of Clinical Oncology (ASCO) recommend germline genetic testing for
all patients with PDAC. However, the best ways to perform this testing and use the resulting information
remain unclear. As genetic testing becomes more common, critical questions need to be addressed: the
number of genes to test; whether testing causes patient distress; and the benefit of PDAC screening in healthy
mutation carriers. Answering these questions will maximize the benefit of genetic testing while minimizing the
risks of over-testing, over-screening, and inefficient use of resources.
My goal is to reduce the burden of pancreatic cancer by identifying optimal ways to execute germline genetic
testing in patients with PDAC and act on the information gained. To accomplish this goal, I will develop a
mathematical model that simulates patient genetic testing and resulting treatment selection, as well as family
member notification, genetic testing, and PDAC screening (Aim 1). I will conduct patient surveys to expand our
understanding of patient distress associated with genetic testing and communication of results to family
members (Aim 2.1). I will use the model and insights gained to determine the timing and breadth of genetic
testing that will optimize life expectancy for patients and family members (Aim 2.2). Finally, I will conduct a
cost-effectiveness analysis of germline genetic testing in PDAC that takes into account diagnosis, treatment,
and family genetic testing in an innovative structure (Aim 3). This will allow me to identify effective and high-
value genetic testing strategies for patients with PDAC, including benefits to patients and their family members.
Completion of this project will be a critical step towards my goal of becoming an independent clinician-scientist
focused in disease modeling, genetic testing, and cancer outcomes research. In addition to my ongoing role
as a clinician and teacher, I will undertake an educational program that has been specifically designed to
support this project and my career goals. I have assembled a mentorship team with unique strengths in cancer
modeling, cancer genetics, and pancreatic cancer research, all of whom are strong, independent investigators
who can guide my career development. This award will provide critical support to allow me to broaden my
knowledge base, leverage the expertise of a senior mentorship team, secure independent R01 funding, and
support my transition to independence in the years to come.
Terms: <1-OHP><1st degree relative><ASCO><Address><American Society of Clinical Oncology><Award><BRCA2 Mutation><BRCA2 gene mutation><Calibration><Cancer Model><CancerModel><Cancers><Cessation of life><Clinical><Clinical Trials><Communication><Cost Analyses><Cost Analysis><Cost Effectiveness Analysis><DNA Alteration><DNA Sequence Alteration><DNA mutation><Data><Death><Decision Analysis><Detection><Development><Development Plans><Diagnosis><Distress><Education><Educational aspects><Effectiveness><Evaluation><Family member><First Degree Relative><Funding><Genes><Genetic Alteration><Genetic Change><Genetic Models for Cancer><Genetic defect><Genetic mutation><Germ Lines><Germ-Line Mutation><Germline Mutation><Goals><Hereditary Mutation><Image><Individual><Investigators><Knowledge><Lesion><Life Expectancy><Literature><MR Imaging><MR Tomography><MRI><MRIs><Magnetic Resonance Imaging><Malignant Neoplasms><Malignant Pancreatic Neoplasm><Malignant Tumor><Malignant neoplasm of pancreas><Math Models><Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance><Mentorship><Methodology><Modeling><Mutation><NCCN><NMR Imaging><NMR Tomography><National Comprehensive Cancer Network><Natural History><Notification><Nuclear Magnetic Resonance Imaging><Outcome><Outcomes Research><PDA model><PDAC Model><Pancreas Cancer><Pancreas Ductal Adenocarcinoma><Pancreatic Cancer><Pancreatic Ductal Adenocarcinoma><Patient outcome><Patient-Centered Outcomes><Patient-Focused Outcomes><Patients><Pilot Projects><Position><Positioning Attribute><Probability><Publishing><Recommendation><Research><Research Personnel><Research Resources><Researchers><Resources><Risk><Risk-associated variant><Role><SEER Program><SEER-Surveillance, Epidemiology, and End Results><Scientist><Secure><Selection for Treatments><Sequence Alteration><Solid><Structure><Surveillance, Epidemiology and End Results><Surveillance, Epidemiology, and End Results Program><Survey Instrument><Surveys><Test Result><Testing><Work><Zeugmatography><anti-cancer research><assess cost><cancer research><cancer risk><career><career development><chemotherapy><cost><cost assessment><cost effective><cost effectiveness><cost efficient analysis><cost estimate><cost estimation><cost evaluation><cost-effective analysis><design><designing><developmental><disease model><disorder model><effectiveness analysis><evaluate cost><examine cost><experience><family genetics><gene panel test><gene testing><gene-based testing><genetic approach><genetic panel test><genetic strategy><genetic testing><genome mutation><genomic alteration><germ-line defect><germline variant><imaging><innovate><innovation><innovative><insight><knowledge base><malignancy><mathematic model><mathematical model><mathematical modeling><model-based simulation><models and simulation><multigene panel test><mutation carrier><neoplasm/cancer><oxaliplatin><oxaliplatine><pancreatic ductal adenocarcinoma model><pancreatic malignancy><patient oriented outcomes><pilot study><programs><risk allele><risk gene><risk genotype><risk loci><risk locus><risk minimization><risk variant><screening><screenings><selection of treatment><social role><teacher><therapy selection><treatment selection>