Dr. O'Reilly on the Potential Role of Veliparib in Pancreatic Cancer

Eileen O'Reilly, MD, Winthrop Rockefeller Endowed Chair in Medical Oncology; co-director of Medical Initiatives at the David M. Rubenstein Center for Pancreatic Cancer Research; section head of Hepatopancreaticobilary and Neuroendocrine Cancers; and medical oncologist at Memorial Sloan Kettering Cancer Center, discusses the potential role of veliparib in pancreatic cancer.

Veliparib is a PARP inhibitor that is not yet approved by the FDA for use in any setting, says O’Reilly. A phase II trial presented at the 2020 Gastrointestinal Cancers Symposium examined the addition of veliparib to cisplatin and gemcitabine in treatment-naïve patients with stage III or IV pancreatic cancer with a germline BRCA1/2 or PALB2 mutation. Although a benefit was not observed with the addition of veliparib to combination chemotherapy, a very encouraging survival signal was reported, says O’Reilly.

Specifically, the median progression-free survival was 10.1 months in the triplet arm versus 9.7 months in the doublet arm. Additionally, the median overall survival (OS) in the triplet arm was 15.5 months versus 16.4 months for the doublet arm.

The other point to stress is that there was another subset of patients on the triplet arm who, at a certain time point, if toxicity was limiting, chemotherapy was dropped and there was an option to continue the PARP inhibitor. That subgroup did very well with veliparib, says O’Reilly. Veliparib is an active agent but, when used concurrently with chemotherapy, its use is limited by cytotoxicity, concludes O’Reilly.