Japan Digestive Disease Week 2025
International Session (Panel Discussion)1 (JSGE, JGES, JSH, JSGS)
October 31, 9:30–12:00, Room 9 (Portopia Hotel Main Building Kairaku 3)
IS-PD1-5_G
Clinical outcome of patients with gBRCA1/2 mutation-positive unresectable pancreatic cancer: a multicenter prospective study
- 1
- Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine
[Background and Aims] The prognosis of unresectable pancreatic cancer with a germline (g)BRCA1/2 mutation has not been fully characterized in Japan. we aimed to clarify the clinical outcome of gBRCA1/2 mutation-positive patients.
[Methods] We prospectively analyzed the efficacy of platinum-based regimens and Olaparib in gBRCA1/2 mutation-positive patients who underwent BRACAnalysis® or Comprehensive genomic profiling (CGP) between January 2020 and December 2024.
[Results] The 260 patients were tested by BRACAnalysis® or CGP. gBRCA1/2 mutations were found in 10 patients (3.8%) (BRCA1 : 3, BRCA2 : 7), median age was 63(59-77) years. The overall response rate (ORR) of platinum-based regimen was 77.8%. Eight patients (89%) were treated with olaparib as maintenance therapy, and the median progression-free survival was 6.1 months. 116 patients with negative for gBRCA1/2 mutation were treated platinum-based regimen, and the ORR was 21.6%. The ORR was significantly higher in the gBRCA1/2-positive group than in the gBRCA1/2-negative group (P=0.003). The median overall survival was 37.4 months in the gBRCA1/2 mutation-positive group and 20.8 months in the negative group.
[Conclusion] In Japan, GnP is recommended as first-line therapy for unresectable pancreatic cancer. Whereas, our results suggest that platinum-based regimens and olaparib are effective for gBRCA1/2 mutation-positive patients. Therefore, it is important to perform gBRCA1/2 gene testing as early as possible to select the appropriate therapy.
[Methods] We prospectively analyzed the efficacy of platinum-based regimens and Olaparib in gBRCA1/2 mutation-positive patients who underwent BRACAnalysis® or Comprehensive genomic profiling (CGP) between January 2020 and December 2024.
[Results] The 260 patients were tested by BRACAnalysis® or CGP. gBRCA1/2 mutations were found in 10 patients (3.8%) (BRCA1 : 3, BRCA2 : 7), median age was 63(59-77) years. The overall response rate (ORR) of platinum-based regimen was 77.8%. Eight patients (89%) were treated with olaparib as maintenance therapy, and the median progression-free survival was 6.1 months. 116 patients with negative for gBRCA1/2 mutation were treated platinum-based regimen, and the ORR was 21.6%. The ORR was significantly higher in the gBRCA1/2-positive group than in the gBRCA1/2-negative group (P=0.003). The median overall survival was 37.4 months in the gBRCA1/2 mutation-positive group and 20.8 months in the negative group.
[Conclusion] In Japan, GnP is recommended as first-line therapy for unresectable pancreatic cancer. Whereas, our results suggest that platinum-based regimens and olaparib are effective for gBRCA1/2 mutation-positive patients. Therefore, it is important to perform gBRCA1/2 gene testing as early as possible to select the appropriate therapy.
- Index Term 1: germline BRCA1/2 mutation
- Index Term 2: pancreatic cancer