Pancreatic cancer patients with a particular mutation in their DNA can be treated with platinum-based chemotherapy and live longer. Those without the mutation may not be lucky even after receiving the same treatment.
The ability to define the subsets in patients who should receive tailored treatment based on tumor biology highlights the importance of molecular filing in improving patient outcomes.
Naturally, the DNA gets damaged every day. Body cells are designed to repair any errors in the DNA in many different ways, including HR. But some genes such as the BRCA1 and BRCA2 genes can be mutated and stop repairing the DNA by HR. Mutations in genes such as ATM, CHEK1/2, PALB2, ATRX, ATR, BAP1, BRIP1, and BARD1 can impair the HR too. When homologous recombination stops working, that is when conditions like cancer develop.
After examining data on patients with advanced pancreatic cancer and those whose tumors had been wholly or partially removed through surgery, researchers also sought to find out if they also had a specific mutation called homologous recombination (HR). This type of mutation impairs the body’s DNA repair process.
The patients selected in the study had mutations in HR genes (germline mutations) or had somatic mutations (mutations found in tumor tissue).
Those with metastatic disease and HR-related mutations managed to live 11 months longer after receiving platinum-based chemotherapy treatment. Those without the HR-related mutations did not live long.
This concludes that cancers that have HR-related mutations are vulnerable to platinum-based chemotherapy. However, platinum-based chemotherapy can only benefit certain patients and not all. Only a percentage of pancreatic cancers have HR-related mutations.
That is why platinum-based therapy cannot be the first-line of treatment for many other patients. Before getting treated, it is recommended that patients undergo molecular profiling to help identify mutations, especially those that can impact their treatment options.