Just maintenance.

A small proportion of patients with advanced pancreatic cancer have germline BRCA or PALB2 mutations. Wait, what’s PALB2 again? It’s an important protein in homologous recombination repair protein that is basically a partner of BRCA2. It has been associated with familial pancreatic cancer and also confers susceptibility to PARP-inhibitors similar to BRCA mutations. Remember, olaparib was approved in a split FDA decision in December as maintenance therapy for advanced pancreatic cancer following platinum-based chemo based on the results of the POLO trial. Here we have results from a randomized phase 2 trial where the veliparib was added concurrently to front-line gemcitabine and cisplatin chemo for advanced pancreatic cancer with pathogenic germline mutations in BRCA/PALB2. Unfortunately, there was no improvement in the primary outcome of response rate nor were there signals of improved progression-free or overall survival. TBL: The PARP-inhibitor veliparib had disappointing results for pancreatic cancer with mutations in BRCA/PALB2. | O’Reilly, J Clin Oncol 2020