Systemic treatments in pancreatic cancer: Taiwan pancreas society recommendation

Su, Yung-Yeh; Chiang, Nai-Jung; Chiu, Tai-Jan; Huang, Chien-Jui; Hsu, Shao-Jung; Lin, Hsin-Chen; Yang, Shih-Hung; Yang, Youngsen; Chou, Wen-Chi; Chen, Yen-Yang; Bai, Li-Yuan; Li, Chung-Pin; Chen, Jen-Shi

doi:10.1016/j.bj.2023.100696

Cited by 2 publications

(1 citation statement)

References 92 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Due to the delayed reimbursement of nab-paclitaxel (reimbursed in 2019) and FOLFIRINOX (reimbursed in 2021), a great proportion of patients in the current study participated in investigator-initiated trials (IITs), as the treatment options were very limited in Taiwan at that time (Additional file 1 : Fig. S3) [ 34 – 42 ]. Therefore, during the study period (2013–2020), the majority of patients received SLOG, either in IITs or in daily practice, while nab-paclitaxel plus gemcitabine was used after its reimbursement in 2019 (Additional file 1 : Fig.…”

Section: Resultsmentioning

confidence: 99%

Germline mutations of homologous recombination genes and clinical outcomes in pancreatic cancer: a multicenter study in Taiwan

Cheng,

Su,

Chiang

et al. 2024

J Biomed Sci

Self Cite

View full text Add to dashboard Cite

Background Cancer susceptibility germline mutations are associated with pancreatic ductal adenocarcinoma (PDAC). However, the hereditary status of PDAC and its impact on survival is largely unknown in the Asian population. Methods Exome sequencing was performed on 527 blood samples from PDAC individuals and analyzed for mutations in 80 oncogenic genes. Pathogenic and likely pathogenic (P/LP) germline variants were diagnosed according to the ACMG variant classification categories. The association between germline homologous recombination gene mutations (gHRmut, including BAP1, BRCA1, BRCA2, PALB2, ATM, BLM, BRIP1, CHEK2, NBN, MUTYH, FANCA and FANCC) and the treatment outcomes was explored in patients with stage III/IV diseases treated with first-line (1L) platinum-based versus platinum-free chemotherapy. Results Overall, 104 of 527 (19.7%) patients carried germline P/LP variants. The most common mutated genes were BRCA2 (3.60%), followed by ATR (2.66%) and ATM (1.9%). After a median follow-up duration of 38.3-months (95% confidence interval, 95% CI 35.0–43.7), the median overall survival (OS) was not significantly different among patients with gHRmut, non-HR germline mutations, or no mutation (P = 0.43). Among the 320 patients with stage III/IV disease who received 1L combination chemotherapy, 32 (10%) had gHRmut. Of them, patients receiving 1L platinum-based chemotherapy exhibited a significantly longer median OS compared to those with platinum-free chemotherapy, 26.1 months (95% CI 12.7–33.7) versus 9.6 months (95% CI 5.9–17.6), P = 0.001. However, the median OS of patients without gHRmut was 14.5 months (95% CI 13.2–16.9) and 12.6 months (95% CI 10.8–14.7) for patients receiving 1L platinum-based and platinum-free chemotherapy, respectively (P = 0.22). These results were consistent after adjusting for potential confounding factors including age, tumor stage, performance status, and baseline CA 19.9 in the multivariate Cox regression analysis. Conclusions Our study showed that nearly 20% of Taiwanese PDAC patients carried germline P/LP variants. The longer survival observed in gHRmut patients treated with 1L platinum-based chemotherapy highlights the importance of germline testing for all patients with advanced PDAC at diagnosis.

show abstract

Section: Resultsmentioning

confidence: 99%