Early Outcomes Of A High-Risk Cohort In Pancreatic Cancer Surveillance.

e16258 Background: By 2030 pancreatic cancer will become the third leading cause of cancer related death in the United States. Genetic evolution studies have suggested the existence of a window of opportunity to improve clinical outcomes by intercepting pre-malignant lesions. This study reports the outcome of pancreatic cancer surveillance in a cohort of PDAC High Risk patients followed at The University of Texas MD Anderson Cancer Center (MDA) between 2015-2018. Methods: The MDA PDAC High-Risk Clinic (MDA-PCHRC) performs surveillance based on risk stratification. The first patient screened under this methodology was seen on March 2015 and this study reports 36 months of surveillance from the date of the first high-risk consult. The referred patients are risk stratified into mild, moderate, and high-risk groups. PDAC risk stratification criteria include PDAC family history, diabetes, chronic pancreatitis and germline mutations with higher susceptibility to PDAC. Patients in the moderate or high-risk category get annual screening with blood markers (CA 19-9, fasting glucose, hemoglobin A1C, amylase, lipase) and magnetic resonance imaging/ cholangiopancreatography (MRI/MRCP). The high-risk group also receives an endoscopic ultrasound (EUS) at baseline. We evaluate the methodology and yield of premalignant lesions in the MDA-PCHRC. Results: A total of 121 patients have been referred to our clinic during this time period. From this group, 71 patients completed at least one cycle of baseline surveillance. Currently, we have identified 4 side branch duct IPMNs, 4 simple cysts and 9 imaging findings of pancreatic parenchymal changes. There has been 1 duodenal neuroendocrine tumor, 1 pancreatic neuroendocrine tumorlet, and 1 high grade IPMN as per biopsy findings. Conclusions: Early results show that screening at the MDA-PCHRC with EUS, MRI/MRCP, and laboratory markers is safe and can detect premalignant lesions. However, further follow up is warranted to thoroughly assess the efficacy of pancreatic cancer screening in a high-risk populations. Moreover, patients followed in our clinic are enrolled into a Prospective Cohort and their biospecimens (blood and urine) are prospectively collected for future biomarkers validation.