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Mitomycin C in Homologous Recombination Deficient Metastatic Pancreatic Cancer after Disease Progression on

Gehan Botrus1,2, Denise Roe3, Gayle S Jameson1

  • 1HonorHealth Research Institute, Scottsdale, AZ 85258, USA.

Biomedicines
|November 11, 2022
PubMed

Insights

Mitomycin C (MMC) shows promise for treating homologous recombinant deficient (HRD) metastatic pancreatic cancer (MPC) that is resistant to standard therapies. Responses were seen in patients with BRCA2 mutations, indicating potential for targeted treatment.

Area of Science:

  • Oncology
  • Medical Research
  • Genetics

Background:

  • Personalized treatment for homologous recombinant deficient (HRD) metastatic pancreatic cancer (MPC) using platinum-based chemotherapy and PARP inhibitors shows promise.
  • Resistance to current therapies necessitates the development of novel treatment strategies for HRD MPC.

Purpose of the Study:

  • To evaluate the safety and efficacy of Mitomycin C (MMC) in patients with HRD metastatic pancreatic cancer (MPC) who have progressed on prior treatments.
  • To identify potential predictive markers for response to MMC in this patient population.

Main Methods:

  • A case series of five HRD MPC patients treated with Mitomycin C (MMC) between January 2013 and July 2018 was retrospectively analyzed.
  • Patients had progressed on platinum-based chemotherapy, with four having prior exposure to Olaparib.
  • Clinical outcomes including progression-free survival (PFS) and overall survival (OS), as well as toxicities, were assessed.

Main Results:

  • The median PFS was 10.1 months and the median OS was 12.3 months.
  • Tumor responses were observed exclusively in patients with BRCA2 mutations; no response was noted in a PALB2 mutation carrier.
  • MMC was generally safe, with manageable grade 2 gastrointestinal toxicities and grade 3 hematological toxicities.

Conclusions:

  • Mitomycin C (MMC) may offer a potential treatment benefit for pancreatic cancer patients with HRD, particularly those with BRCA2 mutations.
  • Further clinical investigation of MMC in pancreatic cancer is warranted to confirm these findings and optimize its use.
Keywords:
BRCAOlaparibhomologous recombination deficientmitomycinpancreatic cancer

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