Dr. Saif on the Rationale to Utilize PARP Inhibitors in BRCA+ Pancreatic Cancer

Wasif M. Saif, MD, MBBS, deputy physician in chief, director of medical oncology, Northwell Health Cancer Institute, professor of medical oncology, Donald and Barbara Zucker School of Medicine, Hofstra/Northwell, discusses the rationale to utilize PARP inhibitors in BRCA-mutated pancreatic cancer.

In the United States, pancreatic cancer accounts for approximately 3% of all cancers and about 7% of all cancer deaths. Although this is a relatively low incidence compared with other solid malignancies, pancreatic cancer is a leading cause of cancer-related death, Saif says. Additionally, the disease is highly resistant to chemotherapy and radiation therapy.

The current standard of care for patients with pancreatic cancer is FOLFIRINOX or gemcitabine plus nab-paclitaxel (Abraxane). Although these regimens provide disease control, the cancer eventually becomes resistant to the chemotherapy, Saif explains.

Notably, it was discovered that patients with DNA damage repair deficient tumors, such as those that harbor BRCA mutations, are sensitive to platinum-based chemotherapy, Saif says. However, these tumors are particularly responsive to PARP inhibitors as a salvage DNA repair pathway. As such, PARP inhibitors should be utilized in patients with BRCA-mutated pancreatic cancer to provide a progression-free survival advantage, Saif concludes.