Personalizing Pancreatic Cancer Treatment

Pancreatic cancer with BRCA mutations respond to PARP inhibitor

(RxWiki News) Angelina Jolie has put BRCA gene mutations on the red carpet. But changes in this gene play a role in more than breast and ovarian cancers. Faulty BRCA 1 and 2 proteins can also be involved in pancreatic and prostate cancer.

An experimental oral medication known as olaparib has been shown to be effective in treating advanced pancreatic and prostate cancers that had BRCA mutations.

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Susan Domchek, MD, director of the University of Pennsylvania Basser Research Center for BRCA, was senior author of the study.

"Pancreatic cancer treatment remains a difficult challenge. One approach has been to find subpopulations of tumors with biomarkers and to develop a more personalized approach to therapy,” James Farrell, MD, Director of Yale University Center for Pancreas Diseases, told dailyRx News.

“Familial pancreatic cancer accounts for about 10 to 15 percent of all cases of pancreatic cancer with the BRCA mutation being the most common,” explained Dr. Farrell, who was not involved in this study.

For this international study, researchers in the US, Europe, Australia and Israel studied 300 patients with advanced cancers who had BRCA mutations.

The patients with breast, ovarian, pancreatic, prostate and other cancers all took olaparib.

Olaparib is a PARP inhibitor. That means it blocks a protein known as poly (ADP ribose) polymerase (PARP). Both PARP and the BRCA genes are involved in DNA repair. The medicine works to keep cancer cells from renewing themselves and growing.

The researchers discovered the following:

  • 22 percent of pancreatic cancer patients and 50 percent of prostate cancer patients responded to the therapy.
  • After eight weeks on the medication, 35 percent of the pancreatic cancer patients had stable disease, as did 25 percent of the advanced prostate cancer patients.
  • After one year, 41 percent of pancreatic cancer patients were still alive, compared to the normal average one-year survival rate of 26 percent.
  • 50 percent of the advanced prostate cancer patients were also alive after one year.
  • Results in breast cancer patients were also impressive, with 45 percent of metastatic breast cancer patients still alive at one year.

“Although the numbers are small, the initial response rates, disease progression rates and one year outcomes data warrant further investigations,” Dr. Farrell said. “This study represents a step in the right direction for the development of personalized treatments for pancreatic cancer."

Olaparib was well tolerated, with the most common side effects being fatigue, nausea and periodic vomiting.

This study will be presented during the American Society of Clinical Oncology's annual meeting in early June. All research is considered preliminary before it is published in a peer-reviewed journal.

Review Date: 
May 22, 2013