Response of <i>BRCA1</i>-mutated gallbladder cancer to olaparib: A case report

Xie, Yuan; Jiang, Yan; Yang, Xiaobo; Wang, An-Qiang; Zheng, Yongchang; Wan, Xueshuai; Sang, Xinting; Wang, Kai; Zhang, Dadong; Xu, Jiajia; Li, Fugen; Zhao, Haitao

doi:10.3748/wjg.v22.i46.10254

Cited by 25 publications

(18 citation statements)

References 22 publications

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“…Previous studies have suggested that similar to ovarian and breast cancers, cholangiocarcinoma harboring BRCA-associated gene alterations are more sensitive to platinum-based therapy. [34][35][36] In fact, when we investigated the patients treated with gemcitabine and platinums in this series, the matched group tended to have a longer median PFS, although there was no statistical significance (5.8 versus 3.1 months; Supplementary Figure 2). We also assessed the treatment outcomes according to the matching score (the number of targeted gene alterations divided by the total number of alterations observed in NGS; unmatched patients had a score of 0%) as reported previously.…”

Section: Discussionmentioning

confidence: 81%

Comprehensive Genomic Landscape and Precision Therapeutic Approach in Biliary Tract Cancers

Okamura¹,

Kurzrock²,

Mallory³

et al. 2020

SSRN Journal

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College of American Pathologist (CAP); circulating-tumor DNA (ctDNA); clinical laboratory improvement amendments (CLIA); combined or mixed cholangio-hepatocellular carcinoma (C-HCC); complete response (CR); confidence interval (CI); Eastern Cooperative Oncology Group Performance Status (ECOG-PS); extrahepatic cholangiocarcinoma (EHCC); gallbladder cancer (GBCA); gemcitabine plus oxaliplatin (GEMOX); hazard ratio (HR); immunohistochemistry (IHC); intrahepatic cholangiocarcinoma (IHCC); micro microsatellite instability (MSI); next-generation sequencing (NGS); overall survival (OS); partial response (PR); programmed death-ligand 1 (PD-L1); progression-free survival (PFS); progressive disease (PD); Response Evaluation Criteria in Solid Tumors (RECIST); stable disease (SD); tumor mutational burden (TMB).

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Section: Discussionmentioning

confidence: 81%

Comprehensive Genomic Landscape and Precision Therapeutic Approach in Biliary Tract Cancers

Okamura¹,

Kurzrock²,

Mallory³

et al. 2020

SSRN Journal

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“…In addition to breast, ovarian and prostate cancer, there have been previous reports on the use of olaparib in the treatment of PDAC and gallbladder cancer. [ 17 , 31 ] However, there is no report of PACC with a BRCA2 mutation that responded to the PARP inhibitor-olaparib before this case.…”

Section: Discussionmentioning

confidence: 99%

Response of germline BRCA2-mutated advanced pancreatic acinar cell carcinoma to olaparib

Li¹,

Mou²,

Hou³

et al. 2018

Medicine

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Rationale:Pancreatic acinar cell carcinoma (PACC) is a relatively rare malignancy of the exocrine pancreas. BRCA2, a cancer susceptibility gene, has been widely studied in breast and ovarian carcinomas as mutation carriers for this gene are at a high risk for cancer development. Olaparib, an oral poly(adenosine diphosphate-ribose) polymerase (PARP) inhibitor, has been approved for the treatment of ovarian cancer with any BRCA 1/2 mutations. Herein, we report the first case of a germline BRCA2-mutated unresectable advanced PACC patient who responded well to olaparib treatment.Patient concerns:A 59-year-old male with a family history of cancer presented with a persistent epigastric dull pain for 3 months.Diagnosis:The patient was diagnosed with advanced PACC based on computed tomography (CT) scan, laparotomy, and pathology.Interventions:Exploratory laparotomy, intratumoral brachytherapy by radioiodine-125 seeds, modified FOLFIRINOX chemotherapy, and targeted therapy with olaparib were administered.Outcomes:The patient responded well to olaparib until the occurrence of severe adverse drug reactions, he died as a result of multiple organ failure with an overall survival period of 12 months.Lessons:As a PARP inhibitor, olaparib has remarkable curative effect not only on breast and ovarian cancers, but also on other malignancies with BRCA mutations. Patients with advanced cancer could benefit from active targeted therapy with improvement in overall survival and quality of life.

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“…BRCA1 and BRCA2 CCA mutated cases with prolonged PFS to PARP inhibitors have been reported. 84,85 Finding of this mutation because of a suspicious family history but also because of the use of molecular panels might be beneficial to these patients and their family members, enabling assessment of their cancer development risk and the effectiveness of new anticancer drugs as PARPi but also of the traditional platine agents as happens in other solid tumours. Other predictive responsive factors to PPARi such ARID1A mutation, common in CCA, have also been suggested.…”

Section: Brcaimentioning

confidence: 99%

Medical treatment for cholangiocarcinoma

Adeva

Sangro

Salati

et al. 2019

Liver International

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Most of the patients with cholangiocarcinoma (CCA) present with advanced (inoperable or metastatic) disease, and relapse rates are high in those undergoing potentially curative resection. Previous treatment nihilism of patients with advanced disease has been replaced by active clinical research with the advent of randomized clinical trials (RCTs) and a much greater effort at understanding molecular mechanisms underpinning CCA. Three RCTs have recently been reported evaluating adjuvant chemotherapy following curative resection; only one of these has the potential to change practice. The BILCAP study failed to meet its primary endpoint by intention‐to‐treat analysis; however, a survival benefit was seen in a preplanned sensitivity analysis (predominantly adjusting for lymph nodes status). This, along with the numerical difference in median overall survival has led to the uptake of adjuvant capecitabine by many clinicians. In patients with advanced disease, the only level 1 data available supports the use of cisplatin and gemcitabine for the first‐line treatment of patients with advanced disease; there is no established second‐line chemotherapy. Previous forays into targeted therapy have proven unfruitful (namely targeting the epithelial growth factor receptor and vascular endothelial growth factor pathways). An increasing number of genomic subtypes are being defined; for some of these on‐target therapeutic options are under active investigation. The most developed are studies targeting IDH‐1 (isocitrate dehydrogenase) mutations and FGFR‐2 (fibroblast growth factor receptor) fusions, with promising early results. Several other pathways are under evaluation, along with early studies targeting the immune environment; these are too premature to change practice to date. These emerging treatments are discussed.

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Response of BRCA1-mutated gallbladder cancer to olaparib: A case report

Cited by 25 publications

References 22 publications

Comprehensive Genomic Landscape and Precision Therapeutic Approach in Biliary Tract Cancers

Comprehensive Genomic Landscape and Precision Therapeutic Approach in Biliary Tract Cancers

Response of germline BRCA2-mutated advanced pancreatic acinar cell carcinoma to olaparib

Medical treatment for cholangiocarcinoma

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