Clinical Characteristics of Patients With Pancreatic Cancer and Pathogenic <i>ATM</i> Alterations

Abstract

The Ataxia-Telangiesctasia, mutated (<i>ATM</i>) gene is involved in a number of DNA damage repair pathways and confers an increased risk for pancreatic ductal adenocarcinoma (PDAC). In this retrospective study, we identified and profiled 22 patients with PDAC and a known somatic or germline pathogenic <i>ATM</i> alteration (case patients). These patients were matched 2:1 by age, stage, and year at diagnosis to patients with PDAC without known <i>ATM</i> alterations. The median overall survival in patients with <i>ATM</i> alterations was 40.2 months compared with 15.5 months in the control population (hazard ratio = 0.14, 95% confidence interval = 0.04 to 0.47, 2-sided <i>P</i> = .001). In multivariable analysis, these findings persisted after adjustment for receipt of platinum therapy and Eastern Cooperative Oncology Group status. These findings suggest that pathogenic <i>ATM</i> alterations may be prognostic for improved outcomes in patients with pancreatic cancer.