Results from the POLO trial: Olaparib may delay cancer progression in metastatic pancreatic cancer patients with BRCA mutations.
Full article: www.nejm.org/doi/full/10.1056/NEJMoa1903387
Note: On 12/27/19, the FDA approved olaparib for treatment of pancreatic cancer in people with a BRCA mutation based on the results of the POLO study.
The POLO clinical trial looks at whether the PARP inhibitor olaparib improves outcomes for those with metastatic pancreatic cancer after platinum-based chemotherapy. (7/3/19) Based on these results
The National Comprehensive Cancer Network (NCCN) develops guidelines for experts on best practice within cancer care. Newer NCCN guideline recommendations for metastatic pancreatic cancer include that clinicians consider
- genetic testing for all patients with pancreatic cancer.
- tumor biomarker testing in patients with metastatic disease.
- combination chemotherapy with modified FOLFIRINOX (leucovorin/5-FU/irinotecan/oxaliplatin) for patients who are able to tolerate it.
For metastatic pancreatic cancer patients, modified FOLFIRINOX (fluorouracil [5-FU], leucovorin, irinotecan, oxaliplatin) or gemcitabine/nab-paclitaxel chemotherapy is recommended as a first treatment approach with surgery.
For patients with BRCA1/2 PALB2 mutations, gemcitabine/cisplatin is recommended as a first treatment approach with surgery. Recent recommendtion updates suggest considering olaparib for mainenance therapy for some patients with BRCA mutations and no progression platinum-based chemotherapy.
NCCN suggests tumor testing for patients with metastatic pancreatic cancer for a biomarker known as Microsatellite Instability (MSI). The immunoncology agent pembrolizumab (Keytruda) has been approved to treat patients with advanced cancer who test MSI high.
Questions To Ask Your Health Care Provider
- How do I get genetic testing for a BRCA mutations?
- Does carrying a mutation in BRCA or another gene change your treatment recommendations for me?
- Should I have biomarker testing?
- Which treatment is the best for me?
- Will my insurance pay for Lynparza to treat my pancreatic cancer?
- Is there a clinical trial that I can join?
Open Clinical Trials
The following clinical trials are currently recruiting pancreatic cancer patients:
- NCT03140670: Maintenance Rucaparib in BRCA1, BRCA2 or PALB2 Mutated Pancreatic Cancer That Has Not Progressed on Platinum-based Therapy This is a phase 2 clinical trial to test safety and effectiveness of the PARP inhibitor rucaparib for people with pancreatic cancer who have mutation in BRCA1, BRCA2 or PALB2.
- NCT02886247: Pancreatic Cancer Registry: For Any Person With a Personal or Family History . This clinical registry of people with a personal or family history of pancreatic cancer will help researchers to identify genes that cause pancreatic cancer to cluster in some families.
- NCT03060720: Systematic Hereditary Pancreatic Cancer Risk Assessment and Implications for Personalized Therapy (Clinical trial. Investigators of this trial hope that by testing all new pancreatic cancer patients, they can determine which individuals benefit from genetic testing so that accurate, evidence-based guidelines can be established for doctors.
FORCE is a national nonprofit organization, established in 1999. Our mission is to improve the lives of individuals and families affected by adult hereditary cancers.