Ann Hepatobiliary Pancreat Surg.  2019 May;23(2):200-205. 10.14701/ahbps.2019.23.2.200.

Impact of BRCA1/2 gene mutations on survival of patients with pancreatic cancer: A case-series analysis

Affiliations
  • 1Department of General and Digestive Surgery, Hospital Universitario Madrid Sanchinarro, Madrid, Spain. drbarzola@gmail.com
  • 2Department of Surgery and General Surgery, Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine.
  • 3Department of Pathology, Hospital Universitario Madrid Sanchinarro, Madrid, Spain.

Abstract

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.

Keyword

Pancreatic adenocarcinoma; BRCA mutations; Cisplatin; Folfirinox; Pathologic complete response

MeSH Terms

Adenocarcinoma
Cisplatin
Genes, BRCA1
Genetic Predisposition to Disease
Humans
Life Expectancy
Neoadjuvant Therapy
Pancreatectomy
Pancreatic Neoplasms*
Radiotherapy
Recurrence
Splenectomy
Survival Rate
Cisplatin
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