Pancreatic Cancer | Michael J Pishvaian, MD, PhD

Pancreatic Cancer Update, Issue 1, 2020 — Our interview with Dr Pishvaian highlights the following topics as well as cases from his practice: Key biologic features of pancreatic cancer (0:00) Genetic alterations and potentially actionable mutations in pancreatic cancer (2:02) Targeting BRCA mutations in pancreatic cancer; incidence of microsatellite instability-high disease (4:44) Current recommendations for genetic testing for patients with pancreatic cancer (6:45) Molecular profiling for patients with pancreatic cancer: The Know Your Tumor® initiative (11:36) Ongoing trials investigating targeted therapies for pancreatic cancer (12:56) Case: A woman in her early 60s with metastatic pancreatic cancer (mPC) and a germline BRCA2 mutation is enrolled on a clinical trial of veliparib with FOLFOX as first-line therapy(14:46) Activity, safety and ongoing evaluation of PARP inhibitors in combination with chemotherapy for mPC (18:05) Case: A woman in her early 60s with mPC and a somatic BRCA2 mutation receives FOLFIRINOX followed by maintenance rucaparib on a clinical trial (20:29) POLO: Design and results of a Phase III trial of olaparib as maintenance therapy for patients with mPC and a germline BRCA mutation after first-line chemotherapy (23:38) Tolerability of maintenance olaparib on the POLO trial (27:42) Clinical implications of the POLO trial results (30:09) Case: A woman in her late 50s with locally advanced pancreatic cancer and a germline ATM mutation is enrolled on a clinical trial of irinotecan, a PARP inhibitor and an ATR inhibitor (34:31) Response to FOLFOX in patients with locally advanced pancreatic cancer and ATM mutations (37:37) Case: A man in his early 60s with mPC with a ROS1 fusion receives entrectinib on a clinical trial (41:22) Clinical experience and dosing considerations with FOLFIRINOX or gemcitabine/nab paclitaxel (44:03) Use of nal-IRI (nanoliposomal irinotecan) with 5-FU/leucovorin for mPC (46:58) Importance of supportive and palliative care for patients with mPC (48:19) Perspective on the use of medical marijuana for patients with mPC (51:47) Choice of gemcitabine/nab paclitaxel or FOLFIRINOX as first-line therapy for mPC (53:43) Selection of adjuvant therapy for patients with pancreatic cancer (55:53) Case: A woman in her mid-50s with localized pancreatic cancer receives neoadjuvant FOLFIRINOX (57:49) Potential role of PARP inhibitors for pancreatic cancer in the adjuvant setting (1:02:24) CME information and select publications