A Long-Term and Sustainable Response to Orapali in a BRCA2 Mutant Advanced Pancreatic Cancer: A Case Report

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Author Info

Leyuan Zhu Xiuming Zhu

Corresponding Author

Xiuming Zhu
Department of Medical Oncology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China

A B S T R A C T

Pancreatic cancer is a highly malignant cancer characterized by high mutation rates of oncogenes and tumor suppressor genes and genomic instability. It has a poor prognosis owing to early metastasis and rapid growth. Therefore, new drugs or treatments are urgent to be required. Poly ADP-Ribose polymerase (PARP) inhibitors have shown therapeutic efficacy in pancreatic cancer driven by defects in homologous recombinant (HRD). Here we report a case of advanced pancreatic cancer with BRCA2 mutation. The patient came to our hospital due to abnormal enlargement of the left supraclavicular lymph node. Further examination revealed pancreatic cancer with multiple retroperitoneal lymph nodes metastases and lung metastases. Pathological and immunohistochemical results of supraclavicular lymph node confirmed it was pancreatic cancer metastasis. Next generation sequencing (NGS) demonstrated that BRCA2 germline mutation. Subsequently, gemcitabine combined with cisplatin as first line therapy was commenced for the patient. The tumors were significant reduced after 6 cycles of treatment. Then, the patient was given orapali (PARP inhibitors) to maintain treatment. Surprisingly, the efficacy has lasted for about 20 months (from Dec 2021 to Aug 2023) and no signs of disease progression have been found. Our case shows that orapali provides a more efficient and low-toxic treatment for patient with BRCA2 mutation advanced pancreatic cancer, which is expected to change the treatment pattern of advanced pancreatic cancer.

Article Info

Article Type

Case Report

Publication history

Received: Tue 15, Aug 2023
Accepted: Wed 30, Aug 2023
Published: Thu 07, Sep 2023

Copyright

© 2023 Xiuming Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.SCR.2023.05.03