The statistics around pancreatic cancer are grim. In the US this year, more than 57,000 people will be diagnosed and approximately 47,000 will die from the disease. Pancreatic cancer is the third leading cause of cancer death, with a five-year survival rate of 10% across all stages.
However, the five-year survival rate has slowly risen from just 6% in 2006. As researchers learn more about this devastating disease, they are discovering more about the role of genetic mutations – abnormal changes in genes – in the development and treatment of pancreatic cancer. Specifically, changes in the BRCA1 and BRCA2 genes, genes that all men and women are born with, have been linked to an increased risk of pancreatic cancer. The good news is that knowing whether a patient with pancreatic cancer has a BRCA1 or BRCA2 mutation can help inform treatment decisions.
Whether you have a family history of pancreatic cancer or have been recently diagnosed, here are five key things to understand about this disease and the role genetics can play.
1. Why is the prognosis for advanced pancreatic cancer typically poor?
Pancreatic cancer is difficult to detect in the early stages, as early-stage tumors typically cannot be felt or seen during routine check-ups. Often there are no symptoms until the cancer has reached an advanced stage. More than 50% of patients are diagnosed at the metastatic stage, meaning the cancer has spread to other parts of the body. At this stage, there are limited treatment options and typically poor outcomes.
2. What are BRCA1 and BRCA2 genes and why are they important in pancreatic cancer?
We all inherit BRCA1 and BRCA2 genes from our parents. Under normal circumstances, these genes suppress tumor growth by producing proteins to help repair damaged DNA and keep the body’s genetic material stable. However, if BRCA genes become altered, they may no longer be able to help suppress tumors, leading to an increased risk of certain types of cancer. BRCA gene mutations may be inherited (carried in the germline) or somatic (acquired and located only in the tumor).
While breast and ovarian cancers are more commonly associated with these mutations, many people may be unaware that the risk of pancreatic cancer is increased in people with BRCA1 or BRCA2 mutations. Studies have shown that 4-7% of pancreatic cancer patients harbor a BRCA1 or BRCA2 mutation. Those with pancreatic cancer who are of Ashkenazi Jewish ancestry are even more likely to carry a BRCA mutation.
3. How do I find out if I have a BRCA mutation?
Whether or not you have been diagnosed with pancreatic cancer, a blood or saliva test can determine if you carry an inherited BRCA gene mutation that puts you at increased risk for developing pancreatic and other cancers. Knowing if these mutations exist can also help to better inform diagnosed pancreatic cancer patients of treatment options and why they might respond to some treatments over others.
“Every patient is different, so testing for genetic mutations at diagnosis is important for metastatic pancreatic cancer patients because it can help doctors determine a personalized treatment plan,” said Julie Fleshman, JD, MBA, president and CEO of the Pancreatic Cancer Action Network (PanCAN). “PanCAN strongly recommends that all pancreatic cancer patients undergo genetic testing for inherited mutations and biomarker testing of their tumor tissue to help them and their healthcare team make informed treatment decisions.”
4. What are the treatment options for advanced pancreatic cancer?
There have been limited treatment advances for pancreatic cancer over the last few years. In pancreatic cancer, only 10-20% of patients are eligible for surgery. In patients whose cancer cannot be removed surgically, chemotherapy is typically given. There is an approved treatment option for patients with an inherited BRCA gene mutation and with metastatic pancreatic cancer.
LYNPARZA® (olaparib), a type of drug known as a PARP (poly [ADP-ribose] polymerase) inhibitor, was approved in December 2019 by the US Food and Drug Administration as a treatment for metastatic pancreatic cancer with an inherited BRCA gene mutation. LYNPARZA is used as a maintenance treatment after the cancer has not progressed during at least 16 weeks of treatment with platinum-based chemotherapy. Your healthcare provider will perform a test to make sure that LYNPARZA is right for you. This test, a companion diagnostic for LYNPARZA, is the FDA-approved diagnostic to determine which patients are eligible for treatment with LYNPARZA.
The availability of this treatment supports the value of testing patients with pancreatic cancer for germline (inherited) BRCA mutations, as it offers a personalized biomarker-led approach for the maintenance treatment of metastatic pancreatic cancer. Previously, there were no approved biomarker-directed treatment options. LYNPARZA is the only approved targeted medicine for biomarker-selected advanced pancreatic cancer patients (those who test positive for a germline BRCA mutation). For more information, visit LYNPARZA.com.
LYNPARZA may cause serious side effects, including bone marrow problems called myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML), and lung problems (pneumonitis). Tell your doctor if you experience any new or worsening symptoms of lung problems, including shortness of breath, fever, cough, or wheezing. See full Important Safety Information below.
5. What resources are available for people with pancreatic cancer?
It’s important for pancreatic cancer patients and their caregivers to learn about the disease and have a support system. The Pancreatic Action Network (PanCAN), a leading patient advocacy and research organization founded in 1999, provides free, in-depth, personalized resources on pancreatic cancer, including one-to-one support from expert case managers, educational materials, clinical trial information and even molecular profiling.
“A diagnosis of pancreatic cancer can be scary and confusing, and people may be unsure where to turn, so PanCAN’s Patient Services is here to help,” said Fleshman. “Knowledge and a strong support system will help empower patients to be their own best advocate and ensure they’re asking the right questions about their treatment options.”
If you or a loved one are newly diagnosed with pancreatic cancer, it is important to talk to your care team about BRCA mutation testing and how the results could inform your future treatment decisions. For more information about pancreatic cancer and the role that genes play, visit www.pancan.org, or contact PanCAN’s Patient Services by calling 1-877-2-PANCAN.
PanCAN is a third-party that is not affiliated with, reviewed, or maintained by AstraZeneca.
IMPORTANT SAFETY INFORMATION
LYNPARZA may cause serious side effects, including:
Bone marrow problems called Myelodysplastic Syndrome (MDS) or Acute Myeloid Leukemia (AML). Some people who have ovarian cancer or breast cancer and who have received previous treatment with chemotherapy, radiotherapy, or certain other medicines for their cancer have developed MDS or AML during treatment with LYNPARZA. MDS or AML may lead to death. If you develop MDS or AML, your healthcare provider will stop treatment with LYNPARZA.
Symptoms of low blood cell counts are common during treatment with LYNPARZA, but can be a sign of serious bone marrow problems, including MDS or AML. Symptoms may include weakness, weight loss, fever, frequent infections, blood in urine or stool, shortness of breath, feeling very tired, bruising or bleeding more easily.
Your healthcare provider will do blood tests to check your blood cell counts:
- before treatment with LYNPARZA
- every month during treatment with LYNPARZA
- weekly if you have low blood cell counts that last a long time. Your healthcare provider may stop treatment with LYNPARZA until your blood cell counts improve
Lung problems (pneumonitis). Tell your healthcare provider if you have any new or worsening symptoms of lung problems, including shortness of breath, fever, cough, or wheezing. Your healthcare provider may do a chest x-ray if you have any of these symptoms. Your healthcare provider may temporarily or completely stop treatment if you develop pneumonitis. Pneumonitis may lead to death.
Before taking LYNPARZA, tell your healthcare provider about all of your medical conditions, including if you:
- have lung or breathing problems
- have kidney problems
- are pregnant, become pregnant, or plan to become pregnant. LYNPARZA can harm your unborn baby and may cause loss of pregnancy (miscarriage)
- If you are able to become pregnant, your healthcare provider may do a pregnancy test before you start treatment with LYNPARZA
- Females who are able to become pregnant should use effective birth control (contraception) during treatment with LYNPARZA and for 6 months after the last dose of LYNPARZA. Talk to your healthcare provider about birth control methods that may be right for you. Tell your healthcare provider right away if you become pregnant or think you might be pregnant following treatment with LYNPARZA
- Males with female partners who are pregnant or able to become pregnant should use effective birth control (contraception) during treatment with LYNPARZA and for 3 months after the last dose of LYNPARZA
- Do not donate sperm during treatment with LYNPARZA and for 3 months after your final dose
- are breastfeeding or plan to breastfeed. It is not known if LYNPARZA passes into your breast milk. Do not breastfeed during treatment with LYNPARZA and for 1 month after receiving the last dose of LYNPARZA. Talk to your healthcare provider about the best way to feed your baby during this time
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Taking LYNPARZA and certain other medicines may affect how LYNPARZA works and may cause side effects.
How should I take LYNPARZA?
- Take LYNPARZA tablets exactly as your healthcare provider tells you
- Do not change your dose or stop taking LYNPARZA unless your healthcare provider tells you to. Your healthcare provider may temporarily stop treatment with LYNPARZA or change your dose of LYNPARZA if you experience side effects
- Your healthcare provider will decide how long you stay on treatment
- Do not take more than 4 LYNPARZA tablets in 1 day. If you have any questions about LYNPARZA, talk to your healthcare provider or pharmacist
- Take LYNPARZA by mouth 2 times a day
- Each dose should be taken about 12 hours apart
- Swallow LYNPARZA tablets whole. Do not chew, crush, dissolve, or divide the tablets
- Take LYNPARZA with or without food
- If you miss a dose of LYNPARZA, take your next dose at your usual scheduled time. Do not take an extra dose to make up for a missed dose
- If you take too much LYNPARZA, call your healthcare provider or go to the nearest hospital emergency room right away
What should I avoid while taking LYNPARZA?
Avoid grapefruit, grapefruit juice, Seville oranges, and Seville orange juice during treatment with LYNPARZA since they may increase the level of LYNPARZA in your blood.
LYNPARZA may cause serious side effects (see above). The most common side effects of LYNPARZA are:
- nausea or vomiting. Tell your healthcare provider if you get nausea or vomiting. Your healthcare provider may prescribe medicines to treat these symptoms
- tiredness or weakness
- low red blood cell counts
- loss of appetite
- low white blood cell counts
- changes in the way food tastes
- shortness of breath
- indigestion or heartburn
- low platelet counts
- upper stomach area (abdominal) pain
These are not all the possible side effects of LYNPARZA. Call your healthcare provider for medical advice about side effects.
WHAT IS LYNPARZA?
LYNPARZA is a prescription medicine used to treat adults who have:
- advanced ovarian cancer, fallopian tube cancer, or primary peritoneal cancer with a certain type of inherited (germline) or acquired (somatic) abnormal BRCA gene. LYNPARZA is used alone as maintenance treatment after the cancer has responded to your first treatment with platinum-based chemotherapy. Your healthcare provider will perform a test to make sure that LYNPARZA is right for you
- advanced ovarian cancer, fallopian tube cancer, or primary peritoneal cancer with a certain type of abnormal BRCA gene or a positive laboratory tumor test for genomic instability called HRD. LYNPARZA is used in combination with another anti-cancer medicine, bevacizumab, as maintenance treatment after the cancer has responded to your first treatment with platinum-based chemotherapy. Your healthcare provider will perform a test to make sure that LYNPARZA is right for you
- ovarian cancer, fallopian tube cancer, or primary peritoneal cancer, as maintenance treatment, when the cancer has come back. LYNPARZA is used after the cancer has responded to treatment with platinum-based chemotherapy
- advanced ovarian cancer with a certain type of abnormal inherited BRCA gene, and have received treatment with 3 or more prior types of chemotherapy medicines. Your healthcare provider will perform a test to make sure that LYNPARZA is right for you
- a certain type of abnormal inherited BRCA gene, human epidermal growth factor receptor 2 (HER2)-negative breast cancer that has spread to other parts of the body (metastatic). You should have received chemotherapy medicines, either before or after your cancer has spread. If you have hormone receptor (HR)-positive disease, you should have been treated with hormonal therapy. Your healthcare provider will perform a test to make sure that LYNPARZA is right for you
- metastatic pancreatic cancer with a certain type of abnormal inherited BRCA gene. LYNPARZA is used as a maintenance treatment after your cancer has not progressed on at least 16 weeks of treatment with platinum-based chemotherapy. Your healthcare provider will perform a test to make sure LYNPARZA is right for you
It is not known if LYNPARZA is safe and effective in children.
Please click here for complete Prescribing Information, including Patient Information (Medication Guide).
This article is sponsored by AstraZeneca.
LYNPARZA is a registered trademark of the AstraZeneca group of companies.
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