- Neoadjuvant treatment with FOLFIRINOX (folinic acid, fluorouracil, irinotecan, oxaliplatin) is associated with a better pathologic complete response rate among patients with borderline resectable pancreatic ductal adenocarcinoma (PDAC) positive for BRCA2 mutation vs mutation negative.
Why this matters
- The results suggest that resectable PDAC with BRCA mutations should be considered for platinum-based therapy early in the course of disease.
- Dual-center retrospective analysis of 61 patients who underwent surgery after neoadjuvant treatment with FOLFIRINOX.
- Funding: Authors report various financial associations with the pharmaceutical industry.
- 39 patients underwent BRCA testing; 9 had BRCA2 germline mutations.
- Those with germline BRCA mutations had a higher pathologic complete response than non-BRCA carriers (44.4% vs 10%; P=.009).
- Median DFS was not reached among those with BRCA mutations, however, compared with 7 months for those without them (P=.03).
- Median OS did not differ significantly between carriers and noncarriers.
- During a mean follow-up of 33.7 months, 8 patients who had a pathologic complete response remained disease free.
- Small population.