Genetic causes of hereditary pancreatic cancer: BRCA and beyond

Questions To Ask Your Health Care Provider

• Should I have genetic testing for an inherited mutation? 
• I had genetic testing in the past, should I have additional testing? 
• Should I have pancreatic cancer screening? 
• Will my insurance pay for pancreatic cancer screening?

Open Clinical Trials

The following studies are looking at risk management for pancreatic cancer:

• NCT03250078: A Pancreatic Cancer Screening Study in Hereditary High-Risk Individuals. The main goal of this study is to screen and detect pancreatic cancer and precursor lesions in individuals with a strong family history or genetic predisposition to pancreatic cancer. Magnetic Resonance Imaging and Magnetic Cholangiopancreatography (MRI/MRCP) will be utilized to screen for early-stage pancreatic cancer or precursor lesions.
• NCT02478892: Preliminary Evaluation of Screening for Pancreatic Cancer in Patients With Inherited Genetic Risk. The study is a prospective, observational study evaluating the utility of endoscopic ultrasound or MRI for the identification of preneoplastic and neoplastic pancreatic lesions in patients at high risk for pancreatic cancer, specifically those with BRCA1/2, ATM or PALB2 mutations.
• NCT03568630: Blood Markers of Early Pancreas Cancer. Identifying biomarkers of early pancreatic ductal adenocarcinoma (PDAC) could facilitate screening for individuals with higher-than-average risk, expedite the diagnosis in individuals with symptoms and substantially improve an individual's chance of surviving the disease.
• NCT02206360: Pancreatic Cancer Early Detection Program (PCEDP). This is study looks at esophageal ultrasound as a screening for pancreatic cancer in high risk individuals. 
• NCT03250078: A Pancreatic Cancer Screening Study in Hereditary High-Risk Individuals. The goal is to screen for pancreatic cancer in individuals with a strong family history or genetic risk using Magnetic Resonance Imaging and Magnetic Cholangiopancreatography (MRI/MRCP).

A number of other clinical trials for pancreatic cancer screening and prevention may be found here.

The following are treatment studies enrolling people diagnosed with pancreatic cancer:

• NCT04548752: Adding Pembrolizumab to Olaparib to Treat Pancreatic Cancer in People with an Inherited BRCA Mutation. This study is researching whether adding the drug pembrolizumab to the PARP inhibitor olaparib works better than olaparib alone for treating metastatic pancreatic cancer in people with an inherited BRCA1 or BRCA2 mutation.
• NCT05252390: NUV-868 Alone and in Combination With PARP Inhibitors in Patients With Advanced Solid Tumors. This study will test how safe and effective the experimental drug NUV-868 is by itself and in combination with a PARP inhibitor in people with different types of advanced cancers. 
• NCT04493060: Treating Metastatic Pancreatic Cancer with an Inherited or Tumor BRCA1/2 or PALB2 Mutation with Niraparib and Dostarlimab. This study looks at how well the PARP inhibitor niraparib and the immunotherapy drug dostarlimab work together in treating patients with metastatic pancreatic cancer, who have an inherited or tumor mutation in BRCA1, BRCA2, PALB2, BARD1, RAD51C or RAD51D.
• NCT04150042: SHARON: A Clinical Trial for Metastatic Cancer With an Inherited BRCA or PALB2 Mutation Using Chemotherapy and Patients’ Own Stem Cells. This study looks at whether melphalan, BCNU, vitamin B12b, and vitamin C, followed by autologous (self) bone marrow stem cell infusion is safe and effective for treating patients with advanced pancreatic cancer or stage 4, HER2-negative breast cancer for people with a BRCA1, BRCA2 or PALB2 inherited mutation. 
• NCT04666740: Pembrolizumab and Olaparib for Metastatic Pancreatic Cancer with Homologous Recombination Deficiency or Exceptional Response to Platinum Chemotherapy.  This is a study for people with metastatic pancreatic cancer with a tumor test result called HRD-positive, or whose disease has responded well to first-line or second-line platinum therapy. The study will compare the combination of the immunotherapy pembrolizumab and the PARP inhibitor olaparib to olaparib alone.
• NCT04858334: Olaparib or Placebo in Patients with Surgically Removed Pancreatic Cancer who have a BRCA1, BRCA2 or PALB2 Mutation (APOLLO). The purpose of EA2192 / APOLLO is to compare the usual approach (observation) to treatment for one year with olaparib, in patients with a BRCA1, BRCA2 or PALB2 mutation.
• NCT04550494: Treating Metastatic Solid Tumors with an Inherited or Acquired Gene Mutation Using the PARP Inhibitor Talazoparib. This study is looking whether the drug talazoparib is safe and effective for treating people with advanced breast, gastric, ovarian, pancreatic, or other cancers with an inherited mutation or an acquired mutation in certain DNA repair genes, such as BRCA1, BRCA2, ATM, CHEK2, PALB2 and others. 

The following are vaccine studies enrolling people with pancreatic cancer:

• NCT05111353: Neoantigen Vaccines in Pancreatic Cancer in the Window Prior to Surgery. This study will look at the safety of an neoantigen vaccines in pancreatic cancer patients following neoadjuvant chemotherapy. Participants will be placed in one of two groups. Group 1 will receive the vaccine following neoadjuvant chemotherapy and surgery. Group 2 will receive the vaccine after neoadjuvant chemotherapy and before surgery.

Other clinical trials for people with pancreatic cancer can be found here.

The following studies are looking at treatment for people with advanced solid tumors. 

• NCT05252390: NUV-868 Alone and in Combination With PARP Inhibitors in Patients With Advanced Solid Tumors.This study will test the safety and effectiveness of the experimental drug NUV-868 alone and combined with a PARP inhibitor in people with advanced solid tumors. This study is open to people whose cancer stopped responding or progressed on PARP inhibitors.
• NCT02264678: Ascending Doses of Ceralasertib in Combination With Chemotherapy and/or Novel Anti Cancer Agents. This is a study of ceralasertib administered orally in combination with chemotherapy regimens and/or novel anticancer agents to patients with advanced cancer. The study is enrolling people with inherited mutations, including BRCA1, BRCA2, ATM, RAD51C, RAD51D, and people with tumors that are HRD-positive.  
• NCT04644068: Study of AZD5305 as Monotherapy and in Combination With Anti-cancer Agents in Patients With Advanced Solid Malignancies (PETRA). This research is designed to learn whether treatment with a new PARP inhibitor, AZD5305, used alone or in combination with anti-cancer agents is safe, tolerable and has anti-cancer activity in patients with advanced solid tumors. The study is open to people who have previously been treated with PARP inhibitors.  
• NCT04267939: ATR Inhibitor Plus Niraparib Study in Advanced Solid Tumors and Ovarian Cancer. This study will look at how well people with advanced solid tumors respond to treatment with the targeted therapy BAY1895344 in combination with the PARP inhibitor niraparib. This study is open to people with inherited mutations in ATM, BRCA1, BRCA2 and other genes. Contact the study coordinator for information about eligibility for people with mutations in other genes. 
• NCT04657068: Treatment with ATR Inhibitor for Advanced or Metastatic Solid Tumors. This study will look at how well a new oral targeted therapy known as an ATR inhibitor works on advanced or metastatic solid tumors with mutations in genes that are linked to DNA damage repair. This study is open to people who have an inherited or acquired BRCA or ATM mutation or whose tumors are HRD-positive. This study is open to people whose cancer stopped responding or progressed on PARP inhibitors.