Skip to main content

An emerging entity: pancreatic adenocarcinoma associated with a known BRCA mutation: clinical descriptors, treatment implications, and future directions.

Publication ,  Journal Article
Lowery, MA; Kelsen, DP; Stadler, ZK; Yu, KH; Janjigian, YY; Ludwig, E; D'Adamo, DR; Salo-Mullen, E; Robson, ME; Allen, PJ; Kurtz, RC; O'Reilly, EM
Published in: Oncologist
2011

BACKGROUND: BRCA1 and BRCA2 germline mutations are associated with an elevated risk for pancreas adenocarcinoma (PAC). Other BRCA-associated cancers have been shown to have greater sensitivity to platinum and poly(ADP-ribose) polymerase (PARP) inhibitors with better clinical outcomes than in sporadic cases; however, outcomes in BRCA-associated PAC have not been reported. METHODS: Patients with a known BRCA1 or BRCA2 mutation and a diagnosis of PAC were identified from the Gastrointestinal Oncology Service, Familial Pancreas Cancer Registry, and Clinical Genetics Service at Memorial Sloan-Kettering Cancer Center. RESULTS: Fifteen patients, five male, with a BRCA1 (n = 4) or BRCA2 (n = 11) mutation and PAC and one patient with a BRCA1 mutation and acinar cell carcinoma of the pancreas were identified. Seven female patients (70%) had a prior history of breast cancer. Four patients received a PARP inhibitor alone or in combination with chemotherapy; three demonstrated an initial radiographic partial response by Response Evaluation Criteria in Solid Tumors whereas one patient had stable disease for 6 months. Six patients received platinum-based chemotherapy first line for metastatic disease; five of those patients had a radiographic partial response. CONCLUSION: BRCA mutation-associated PAC represents an underidentified, but clinically important, subgroup of patients. This is of particular relevance given the ongoing development of therapeutic agents targeting DNA repair, which may potentially offer a significant benefit to a genetically selected population. We anticipate that further study and understanding of the clinical and biologic features of BRCA-mutant PAC will aid in the identification of tissue biomarkers indicating defective tumor DNA repair pathways in sporadic PAC.

Duke Scholars

Published In

Oncologist

DOI

EISSN

1549-490X

Publication Date

2011

Volume

16

Issue

10

Start / End Page

1397 / 1402

Location

England

Related Subject Headings

  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Jews
  • Humans
  • Germ-Line Mutation
  • Genes, BRCA2
  • Genes, BRCA1
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lowery, M. A., Kelsen, D. P., Stadler, Z. K., Yu, K. H., Janjigian, Y. Y., Ludwig, E., … O’Reilly, E. M. (2011). An emerging entity: pancreatic adenocarcinoma associated with a known BRCA mutation: clinical descriptors, treatment implications, and future directions. Oncologist, 16(10), 1397–1402. https://doi.org/10.1634/theoncologist.2011-0185
Lowery, Maeve A., David P. Kelsen, Zsofia K. Stadler, Kenneth H. Yu, Yelena Y. Janjigian, Emmy Ludwig, David R. D’Adamo, et al. “An emerging entity: pancreatic adenocarcinoma associated with a known BRCA mutation: clinical descriptors, treatment implications, and future directions.Oncologist 16, no. 10 (2011): 1397–1402. https://doi.org/10.1634/theoncologist.2011-0185.
Lowery MA, Kelsen DP, Stadler ZK, Yu KH, Janjigian YY, Ludwig E, et al. An emerging entity: pancreatic adenocarcinoma associated with a known BRCA mutation: clinical descriptors, treatment implications, and future directions. Oncologist. 2011;16(10):1397–402.
Lowery, Maeve A., et al. “An emerging entity: pancreatic adenocarcinoma associated with a known BRCA mutation: clinical descriptors, treatment implications, and future directions.Oncologist, vol. 16, no. 10, 2011, pp. 1397–402. Pubmed, doi:10.1634/theoncologist.2011-0185.
Lowery MA, Kelsen DP, Stadler ZK, Yu KH, Janjigian YY, Ludwig E, D’Adamo DR, Salo-Mullen E, Robson ME, Allen PJ, Kurtz RC, O’Reilly EM. An emerging entity: pancreatic adenocarcinoma associated with a known BRCA mutation: clinical descriptors, treatment implications, and future directions. Oncologist. 2011;16(10):1397–1402.

Published In

Oncologist

DOI

EISSN

1549-490X

Publication Date

2011

Volume

16

Issue

10

Start / End Page

1397 / 1402

Location

England

Related Subject Headings

  • Pancreatic Neoplasms
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Jews
  • Humans
  • Germ-Line Mutation
  • Genes, BRCA2
  • Genes, BRCA1
  • Female