Jan 24, 2020

Pancreatic Cancer Update, Issue 1, 2020 — Our interview with Dr Pishvaian highlights the following topics as well as cases from his practice:

• Key biologic features of pancreatic cancer (0:00)
• Genetic alterations and potentially actionable mutations in pancreatic cancer (2:02)
• Targeting BRCA mutations in pancreatic cancer; incidence of microsatellite instability-high disease (4:44)
• Current recommendations for genetic testing for patients with pancreatic cancer (6:45)
• Molecular profiling for patients with pancreatic cancer: The Know Your Tumor® initiative (11:36)
• Ongoing trials investigating targeted therapies for pancreatic cancer (12:56)
• Case: A woman in her early 60s with metastatic pancreatic cancer (mPC) and a germline BRCA2 mutation is enrolled on a clinical trial of veliparib with FOLFOX as first-line therapy(14:46)
• Activity, safety and ongoing evaluation of PARP inhibitors in combination with chemotherapy for mPC (18:05)
• Case: A woman in her early 60s with mPC and a somatic BRCA2 mutation receives FOLFIRINOX followed by maintenance rucaparib on a clinical trial (20:29)
• POLO: Design and results of a Phase III trial of olaparib as maintenance therapy for patients with mPC and a germline BRCA mutation after first-line chemotherapy (23:38)
• Tolerability of maintenance olaparib on the POLO trial (27:42)
• Clinical implications of the POLO trial results (30:09)
• Case: A woman in her late 50s with locally advanced pancreatic cancer and a germline ATM mutation is enrolled on a clinical trial of irinotecan, a PARP inhibitor and an ATR inhibitor (34:31)
• Response to FOLFOX in patients with locally advanced pancreatic cancer and ATM mutations (37:37)
• Case: A man in his early 60s with mPC with a ROS1 fusion receives entrectinib on a clinical trial (41:22)
• Clinical experience and dosing considerations with FOLFIRINOX or gemcitabine/nab paclitaxel (44:03)
• Use of nal-IRI (nanoliposomal irinotecan) with 5-FU/leucovorin for mPC (46:58)
• Importance of supportive and palliative care for patients with mPC (48:19)
• Perspective on the use of medical marijuana for patients with mPC (51:47)
• Choice of gemcitabine/nab paclitaxel or FOLFIRINOX as first-line therapy for mPC (53:43)
• Selection of adjuvant therapy for patients with pancreatic cancer (55:53)
• Case: A woman in her mid-50s with localized pancreatic cancer receives neoadjuvant FOLFIRINOX (57:49)
• Potential role of PARP inhibitors for pancreatic cancer in the adjuvant setting (1:02:24)

CME information and select publications