USCAP 2022 Companion Society Program

Pancreatobiliary Pathology Society Companion Meeting USCAP 2022

Clonal Evolution of Pancreatobiliary Neoplasms

Despite advances in the field, our understanding of the clonal evolution of neuroendocrine neoplasms and macroscopic precursor lesions of the pancreatobiliary tract remains incomplete. Until recently the genetic alterations that contribute to these tumors’ development, progression and resistance to treatment were poorly understood. New and specific genetic alterations have now been identified in precursor lesions and specific cancer phenotypes have been shown to be associated with targetable genomic events. These advances offer pathologists a better understanding of the underlying pathogenesis of these diseases and allow more precise diagnosis and classification. This session will focus on recent advances in our understanding of mechanisms and clinical implications of the clonal evolution of neuroendocrine neoplasms and macroscopic precursors of the pancreatobiliary tract.  Updates in grading and classification and the use of novel diagnostic/prognostic markers for characterization will also be included. These are essential to practicing pathologists and pathology trainees, as they play an increasing and critical role as consultants on test selection and integrated diagnostic interpretation. Dr. Aldo Scarpa will describe molecular tumorigenesis of pancreatic neuroendocrine neoplasia and its implications on diagnosis, disease progression, treatment and prognosis. Dr. Elizabeth Thompson will provide an overview of the genomics of pancreatic cancer development from its macroscopic precursors, including intraductal neoplasms and mucinous cystic neoplasms, along with their impact on our understanding of pancreas cancer biology, diagnosis, and treatment. Dr. Yoh Zen, who has worked on defining and classifying macroscopic precursor biliary tract lesions (tumoral intraepithelial neoplasia), and their molecular associations, will summarize the current state in this rapidly evolving area.

Learning Objectives: Upon completion of this educational activity, learners will be able to:

  1. Describe the underlying molecular alterations in neuroendocrine neoplasms, and their involvement in diagnosis, association with tumor progression, newly updated WHO grading and tumor progression as well as prognosis.
  2. Describe the spectrum of molecular alterations involved in the development and progression of macroscopic precursor lesions of the pancreas (including intraductal neoplasms and mucinous cystic neoplasms) and their importance in diagnostic workup and therapeutic implications.
  3. Understand the classification system for macroscopic precursor lesions of the biliary tree, the genomic basis for invasive carcinoma development and prognostic implications of these molecular alterations.

Continuing Medical Education

The United States and Canadian Academy of Pathology is accredited by the ACCME to provide continuing medical education for physicians.

The United States and Canadian Academy of Pathology designates this live activity for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Session Chairs

Daniela Allende, MD, Cleveland Clinic, Lerner College of Medicine of Case Western University School of Medicine
United States

David Klimstra, MD, Memorial Sloan Kettering Cancer Center
United States