- In patients with pancreatic cancer with BRCA or PALB2 mutations, the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib demonstrated promising antitumor activity and low toxicity.
Why this matters
- 5%-8% of patients with pancreatic cancer have BRCA or PALB2 mutations associated with tumor susceptibility to cumulatively toxic platinum chemotherapies and, possibly, PARP inhibitors.
- Germline testing is now recommended for all pancreatic cancers.
- Interim analysis of data from 19 of 24 enrollees in a single-arm, phase 2 rucaparib maintenance trial (42 patients planned).
- All had received ≥16 weeks of platinum chemotherapy without progression.
- Funding: Clovis Oncology, Basser Young Leadership Council/Center for BRCA.
- Median PFS was 9.1 months at median 8.5-month follow-up.
- Median OS not reached at 8.1-month follow-up.
- Overall response rate was 37.8% (6 partial responses [PRs], 1 complete response), representing 41.1% of those with measurable baseline disease.
- Disease control rate (response + stable disease) was 89.5% for at least 8 weeks.
- For some patients, threshold of PR not reached until 4-6 months, suggesting true rucaparib response rather than delayed platinum effect.
- The most common toxicities were nausea, fatigue, dysgeusia, alanine aminotransferase increase, and diarrhea.
- Unclear whether due to rucaparib or preceding chemotherapy.
- No grade ≥3 toxicities.
- Small sample size, no control group.