Summary
Molecular targeted therapies in pancreatic ductal adenocarcinoma (PDAC) lag behind treatment options in other tumor entities. The POLO trial has provided promising preliminary data for targeting gBRCA in PDAC by the poly(ADP-ribose) polymerase inhibitor (PARPi) olaparib. This review tries to show further potential approaches to exploit faulty DNA repair mechanisms beyond gBRCA and olaparib.
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References
Statistik Austria. Krebserkrankungen in Österreich 2020. 2020.
Conroy T, Desseigne F, Ychou M, Bouché O, Guimbaud R, Bécouarn Y, et al. FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer. N Engl J Med. 2011;364(19):1817–25.
Hoff DDV, Ervin T, Arena FP, Chiorean EG, Infante J, Moore M, et al. Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine. N Engl J Med. 2013;369(18):1691–703.
Wang-Gillam A, Hubner RA, Siveke JT, Hoff DDV, Belanger B, de Jong FA, et al. NAPOLI‑1 phase 3 study of liposomal irinotecan in metastatic pancreatic cancer: final overall survival analysis and characteristics of long-term survivors. Eur J Cancer. 2019;108:78–87.
Moore MJ, Goldstein D, Hamm J, Figer A, Hecht JR, Gallinger S, et al. Erlotinib plus Gemcitabine compared with Gemcitabine alone in patients with advanced pancreatic cancer: a phase III trial of the national cancer institute of Canada clinical trials group. J Clin Oncol. 2007;25(15):1960–6.
Cicenas J, Kvederaviciute K, Meskinyte I, Meskinyte-Kausiliene E, Skeberdyte A, Cicenas J. KRAS, TP53, CDKN2A, SMAD4, BRCA1, and BRCA2 mutations in pancreatic cancer. Cancers. 2017;9(12):42.
Helleday T. The underlying mechanism for the PARP and BRCA synthetic lethality: clearing up the misunderstandings. Mol Oncol. 2011;5(4):387–93.
Park W, Chen J, Chou JF, Varghese AM, Yu KH, Wong W, et al. Genomic methods identify homologous recombination deficiency in pancreas Adenocarcinoma and optimize treatment selection. Clin Cancer Res. 2020;26:3239–47.
Golan T, Hammel P, Reni M, Cutsem EV, Macarulla T, Hall MJ, et al. Maintenance Olaparib for Germline BRCA-mutated metastatic pancreatic cancer. N Engl J Med. 2019;381(4):317–27.
Dahan L, Phelip JM, Malicot KL, Williet N, Desrame J, Volet J, et al. FOLFIRINOX until progression, FOLFIRINOX with maintenance treatment, or sequential treatment with gemcitabine and FOLFIRI.3 for first-line treatment of metastatic pancreatic cancer: A randomized phase II trial (PRODIGE 35-PANOPTIMOX). J Clin Oncol. 2018;36(15_suppl):4000.
Bangee EM, et al. Opportunity costs of receiving palliative chemotherapy for metastatic pancreatic ductal adenocarcinoma. JCO Oncol Pract. 2020;16:e678–e87.
Binder KAR, Mick R, O’Hara M, Teitelbaum U, Karasic T, Schneider C, et al. Abstract CT234: A Phase II, single arm study of maintenance rucaparib in patients with platinum-sensitive advanced pancreatic cancer and a pathogenic germline or somatic mutation in BRCA1, BRCA2 or PALB2. 2019. pp. CT234–CT234.
Kasi A, Chalise P, Williamson SK, Baranda JC, Sun W, Al-Rajabi RMT, et al. Niraparib in metastatic pancreatic cancer after previous chemotherapy (NIRA-PANC): a phase 2 trial. J Clin Oncol. 2019;37(15_suppl):TPS4168–TPS4168.
Kaufman B, Shapira-Frommer R, Schmutzler RK, Audeh MW, Friedlander M, Balmaña J, et al. Olaparib monotherapy in patients with advanced cancer and a germline BRCA1/2 mutation. J Clin Oncol. 2014;33(3):244–50.
Shroff RT, Hendifar A, McWilliams RR, Geva R, Epelbaum R, Rolfe L, et al. Rucaparib monotherapy in patients with pancreatic cancer and a known deleterious BRCA mutation. JCO Precis Oncol. 2018;2018(2):1–15.
Loibl S, O’Shaughnessy J, Untch M, Sikov WM, Rugo HS, McKee MD, et al. Addition of the PARP inhibitor veliparib plus carboplatin or carboplatin alone to standard neoadjuvant chemotherapy in triple-negative breast cancer (BrighTNess): a randomised, phase 3 trial. Lancet Oncol. 2018;19(4):497–509.
O’Reilly EM, Lee JW, Zalupski M, Capanu M, Park J, Golan T, et al. Randomized, multicenter, phase II trial of Gemcitabine and Cisplatin with or without Veliparib in patients with pancreas Adenocarcinoma and a Germline BRCA/PALB2 mutation. J Clin Oncol. 2020;38(13):1378–88.
Heinemann V, Quietzsch D, Gieseler F, Gonnermann M, Schönekäs H, Rost A, et al. Randomized phase III trial of Gemcitabine plus Cisplatin compared with Gemcitabine alone in advanced pancreatic cancer. J Clin Oncol. 2006;24(24):3946–52.
Rebelatto TF, Falavigna M, Pozzari M, Spada F, Cella CA, Laffi A, et al. Should platinum-based chemotherapy be preferred for germline BReast CAncer genes (BRCA) 1 and 2‑mutated pancreatic ductal adenocarcinoma (PDAC) patients? A systematic review and meta-analysis. Cancer Treat Rev. 2019;80:101895.
Tempero MA. NCCN guidelines updates: pancreatic cancer. J Natl Compr Canc Netw. 2019;17(5.5):603–5.
Mosele F, et al. Recommendations for the use of next generation sequencing (NGS) for patient with metastatic cancers: A report from the ESMO Precision Medicine Working Group. Ann Oncol. 2020;S0923-7534(20)39971-3.
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Doleschal, B. Tackling DNA damage repair mechanisms—a promising molecular informed therapeutic approach in pancreatic ductal adenocarcinoma. memo 13, 380–384 (2020). https://doi.org/10.1007/s12254-020-00658-1
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DOI: https://doi.org/10.1007/s12254-020-00658-1