- In patients with advanced pancreatic cancer who receive firstline platinum treatment, a germline or somatic homologous recombination (HR) mutation is associated with improved survival.
Why this matters
- Identification of a validated biomarker can help select patients who are most suitable for platinum therapy.
- 262 patients (median age, 64 years) were identified for the final analysis who had undergone both germline and somatic MSK-IMPACT (Memorial Sloan Kettering integrated mutation profiling of actionable cancer targets) analysis.
- Funding: MSK Cancer Center; others.
- Median follow-up was 21.9 years.
- No difference was seen in germline and somatic HR mutations; therefore, both groups were designated as HR-deficient (HRD).
- Patients with HR deficiency showed significant improvement in OS vs those without (HR, 0.50; P<.01>
- PFS was significantly longer in patients with HRD who received firstline platinum vs those who did not (12.6 vs 4.4 months).
- Patients with HRD who were treated with firstline platinum had a significantly lower risk for progression or death vs those without HRD (HR, 0.44; P<.01>
- In patients with mutations in both gene copies, platinum-based chemotherapy was associated with longer PFS vs other therapies (13.3 vs 3.8 months; P<.0001>
- Biallelic (11%) and core HR mutations (12%) had higher genomic instability and were associated with improved PFS on firstline platinum vs nonplatinum therapy.
- Small subgroups.