Martínez-Galán J, Rodriguez I, Caba O. Importance of BRCA mutation for the current treatment of pancreatic cancer beyond maintenance. World J Gastroenterol 2021; 27(39): 6515-6521 [PMID: 34754149 DOI: 10.3748/wjg.v27.i39.6515]
Corresponding Author of This Article
Octavio Caba, PhD, Professor, Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, Avenida del Conocimiento s/n, Granada 18016, Spain. ocaba@ugr.es
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Joaquina Martínez-Galán, Isabel Rodriguez, Department of Medical Oncology, Virgen de las Nieves University Hospital, Granada 18014, Spain
Octavio Caba, Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, Granada 18016, Spain
Author contributions: Martinez-Galan J designed the overall concept and outline of the manuscript; Caba O contributed to the discussion, and carried out the design of the manuscript; Martinez-Galan J and Rodriguez I contributed to the writing and editing of the manuscript and review of the literature.
Supported byJunta de Andalucía, No. PC-0498-2017 and No. PC-0549-2017.
Conflict-of-interest statement: Joaquina Martinez-Galan, Isabel Rodriguez, and Octavio Caba have nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Octavio Caba, PhD, Professor, Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, Avenida del Conocimiento s/n, Granada 18016, Spain. ocaba@ugr.es
Received: March 16, 2021 Peer-review started: March 16, 2021 First decision: May 1, 2021 Revised: May 10, 2021 Accepted: September 3, 2021 Article in press: September 3, 2021 Published online: October 21, 2021
Abstract
In this editorial, we comment on pancreatic cancer (PC), one of the most aggressive and lethal cancers. Only minimal improvements in survival rates have been achieved over recent years. Available chemotherapeutic regimens have little impact, and surgical resection remains the only reliable curative approach. We address current treatment options for these patients, focusing on the usefulness of breast cancer (BRCA) gene mutation as a prognostic biomarker and predictor of response to chemotherapy. Superior survival outcomes have been reported in patients with PC and mutant BRCA gene treated with first-line platinum-based chemotherapy. Therefore, it appears appropriate to include BRCA gene status among clinical criteria used to select the chemotherapy regimen. In addition, maintenance treatment with poly(ADP-ribose) polymerase inhibitors has been found to improve progression-free survival in patients with PC and mutated BRCA whose disease does not progress after first-line platinum-based chemotherapy. This combination has therefore been proposed as the optimal treatment regimen for these patients.
Core Tip: Pancreatic cancer remains one of the most lethal malignant neoplasms, and available treatments have several limitations. Genetic studies are not currently recommended to support treatment selection. However, breast cancer (BRCA) gene mutation has been associated with superior survival outcomes in patients treated with platinum-based chemotherapy. Hence, it appears appropriate to consider the BRCA gene status of patients with this cancer among clinical criteria for the selection of first-line chemotherapy regimen.
