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KMID : 1143920190230020200
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Annals of Hepato-Biliary-Pancreatic Surgery
2019 Volume.23 No. 2 p.200 ~ p.205
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Impact of BRCA1/2 gene mutations on survival of patients with pancreatic cancer: A case-series analysis
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Navarro Ernesto Barzola
Lopez Emilio Vicente
Quijano Yolanda
Caruso Riccardo
Ferri Valentina
Durand Hipolito
Cabrera Isabel Fabra
Reques Eduardo Diaz
Ielpo Benedetto
Glagolieva Anastasiia Yuriyivna
Plaza Carlos
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Abstract
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BRCA gene mutations are found in up to 10% of pancreatic adenocarcinoma cases. We present a description of 4 cases along with a review of the current literature regarding pathogenesis, target treatment, response and survival rates in these types of malignancies. We describe four cases of pancreatic adenocarcinoma, in three of which the BRCA2 mutation was identified, in one - BRCA1 gene alteration. Two patients underwent surgery following the neoadjuvant treatment with Folfirinox and radiotherapy; in the first case, a distal pancreatectomy with splenectomy was performed and in the second one - the Whipple’s procedure. In both cases, a complete pathological response was reported. Other 2 patients were treated with Folfirinox after BRCA mutation identification and acceptable life expectancy was obtained. The association of pathologic complete response (PCR) with lower rates of local recurrence and better survival in patients with various types of adenocarcinomas is well known. Identification of such patients carrying BRCA mutations could provide an application of better personalized treatment. In some patients with pancreatic cancer, especially when there is clinical or demographic reason to suspect a genetic predisposition, a confirmation of the presence of BRCA mutations could provide an opportunity to use target treatment with beneficial outcomes regarding survival.
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KEYWORD
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Pancreatic adenocarcinoma, BRCA mutations, Cisplatin, Folfirinox, Pathologic complete response
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