BRCA mutated pancreatic cancer: A change is coming

Abstract

Pancreatic cancer remains a leading cause of cancer-related death with few available therapies for advanced disease. Recently, patients with germline BRCA mutations have received increased attention due to advances in the management of BRCA mutated ovarian and breast tumors. Germline BRCA mutations significantly increase risk of developing pancreatic cancer and can be found in up to 8% of patients with sporadic pancreatic cancer. In patients with germline BRCA mutations, platinum-based chemotherapies and poly (ADP-ribose) polymerase inhibitors are effective treatment options which may offer survival benefits. This review will focus on the molecular biology, epidemiology, and management of BRCA-mutated pancreatic cancer. Furthermore, we will discuss future directions for this area of research and promising active areas of research.

Keywords: Pancreatic cancer; Systemic therapy; Platinum chemotherapy; BRCA; Deoxyribonucleic acid repair; Poly (ADP-ribose) polymerase inhibitors

Core Tip: Recent advances in the field of BRCA-mutated pancreatic cancer suggest that these patients benefit from platinum-based chemotherapy regimens. In light of new findings from the Pancreas Cancer Olaparib Ongoing trial, patients with germline BRCA mutations may benefit from maintenance treatment with olaparib, a Poly (ADP-ribose) polymerase inhibitors following response to platinum-based chemotherapy. Based on these important findings, all pancreatic cancer patients should be offered early access to genetic screening in order to identify patients who will benefit from these therapies.