{"doi":"10.1002/cncr.33812","title":"Pancreas cancer and <i>BRCA</i>: A critical subset of patients with improving therapeutic outcomes","abstract":"BACKGROUND: Patients with germline/somatic BRCA1/BRCA2 mutations (g/sBRCA1/2) comprise a distinct biologic subgroup of pancreas ductal adenocarcinoma (PDAC). METHODS: Institutional databases were queried to identify patients who had PDAC with g/sBRCA1/2. Demographics, clinicopathologic details, genomic data (annotation sBRCA1/2 according to a precision oncology knowledge base for somatic mutations), zygosity, and outcomes were abstracted. Overall survival (OS) was estimated using the Kaplan-Meier method. RESULTS: In total, 136 patients with g/sBRCA1/2 were identified between January 2011 and June 2020. Germline BRCA1/2 (gBRCA1/2) mutation was identified in 116 patients (85%). Oncogenic somatic BRCA1/2 (sBRCA1/2) mutation was present in 20 patients (15%). Seventy-seven patients had biallelic BRCA1/2 mutations (83%), and 16 (17%) had heterozygous mutations. Sixty-five patients with stage IV disease received frontline platinum therapy, and 52 (80%) had a partial response. The median OS for entire cohort was 27.6 months (95% CI, 24.9-34.5 months), and the median OS for patients who had stage IV disease was 23 months (95% CI, 19-26 months). Seventy-one patients received a poly(adenosine diphosphate ribose) polymerase (PARP) inhibitor (PARPi), and 52 received PARPi monotherapy. For maintenance PARPi, 10 patients (36%) had a partial response, 12 (43%) had stable disease, and 6 (21%) had progression of disease as their best response. Six patients (21%) received maintenance PARPi for >2 years. For those with stage IV disease who received frontline platinum, the median OS was 26 months (95% CI, 20-52 months) for biallelic patients (n = 39) and 8.66 months (95% CI, 6.2 months to not reached) for heterozygous patients (n = 4). The median OS for those who received PARPi therapy was 26.5 months (95% CI, 24-53 months) for biallelic patients (n = 25) and 8.66 months (95% CI, 7.23 months to not reached) for heterozygous patients (n = 2). CONCLUSIONS: g/sBRCA1/2 mutations did not appear to have different actionable utility. Platinum and PARPi therapies offer therapeutic benefit, and very durable outcomes are observed in a subset of patients who have g/sBRCA1/2 mutations with biallelic status.","journal":"Cancer","year":2021,"id":163392,"datarank":1.2306459727159607,"base_score":3.7612001156935624,"endowment":3.7612001156935624,"self_citation_contribution":0.5641800173540344,"citation_network_contribution":0.6664659553619263,"self_endowment_contribution":0.5641800173540344,"citer_contribution":0.6664659553619263,"corpus_percentile":83.32172971300379,"corpus_rank":2157,"citation_count":42,"citer_count":30,"citers_with_citation_signal":24,"citers_with_endowment":24,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.5381,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":683055,"name":"Catherine O’Connor","orcid":"0000-0003-4080-9149","position":1,"is_corresponding":false},{"id":231583,"name":"Joanne F. 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Abou‐Alfa","orcid":"0000-0002-1522-8054","position":19,"is_corresponding":false},{"id":239550,"name":"Erin Salo‐Mullen","orcid":"0000-0002-9602-8264","position":20,"is_corresponding":false},{"id":108796,"name":"Zsofia K. Stadler","orcid":"0000-0002-6985-2864","position":21,"is_corresponding":false},{"id":14372,"name":"Christine A. Iacobuzio–Donahue","orcid":"0000-0002-4672-3023","position":22,"is_corresponding":false},{"id":242198,"name":"Eileen M. 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