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Review
. 2020;5(1):e000578.
doi: 10.1136/esmoopen-2019-000578. Epub 2020 Sep 30.

Efficacy of platinum-based chemotherapy and prognosis of patients with pancreatic cancer with homologous recombination deficiency: comparative analysis of published clinical studies

Ilya Pokataev  1 , Mikhail Fedyanin  2 , Elizaveta Polyanskaya  1 , Anna Popova  1 , Julia Agafonova  1 , Sophia Menshikova  1 , Alexey Tryakin  1 , Alexey Rumyantsev  1 , Sergei Tjulandin  1
Affiliations
Review

Efficacy of platinum-based chemotherapy and prognosis of patients with pancreatic cancer with homologous recombination deficiency: comparative analysis of published clinical studies

Ilya Pokataev et al. ESMO Open. 2020.

Abstract

The aim of our study was to determine the effect of homologous recombination deficiency (HRD) on prognosis and efficacy of platinum-based chemotherapy in patients with pancreatic cancer (PC). We performed PubMed and Embase database queries. We included 4 studies into the meta-analysis and 16 studies in the systematic review. Our systematic analysis showed that the average weighted median overall survival (OS) in patients with HRD with advanced PC was 19.8 and 15.6 months in patients without HRD. With platinum-based chemotherapy, the average weighted median OS in patients with HRD was 23.8 and 17.1 months in patients without HRD. Without platinum-based chemotherapy, the average weighted median OS in patients with HRD was 8.3 and 12.0 months in patients without HRD. For resected PC, our meta-analysis demonstrated that HRD status did not affect the prognosis (HR 1.03, 95% CI 0.46 to 2.33), but results were rather heterogeneous (I2=83%, p=0.003). Our systematic analysis showed that the average weighted median OS in patients with HRD was 34.6 and 27.0 months in patients without HRD. With platinum-based chemotherapy, the average weighted median OS in patients with HRD was 46.1 and 36.3 months in patients without HRD. Without platinum-based chemotherapy, the average weighted median OS in patients with HRD was 24.2 and 42.9 months in patients without HRD. Results of our meta-analysis and systematic review support the idea of platinum use in patients with HRD both in resected and metastatic PCs, although a randomised trial is warranted to make a more reliable conclusion. PROSPERO REGISTRATION NUMBER: CRD42019121914.

Keywords: BRCA; homologous recombination; pancreatic neoplasm; platinum.

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Conflict of interest statement

Competing interests: The content of this manuscript has not been copyrighted or published previously, is not under consideration for publication elsewhere, and will not be copyrighted, submitted or published elsewhere while acceptance by the journal is under consideration. There are no directly related manuscripts or abstracts, published or unpublished, by any authors of this paper.

Figures

Figure 1
Figure 1
Publication search strategy flowchart. IV, Inverse Variance
Figure 2
Figure 2
HR for death in patients with resected pancreatic cancer due to HRD. HRD, homologous recombination deficiency.
Figure 3
Figure 3
HR for death in patients with resected pancreatic cancer due to HRD and use of platinum chemotherapy. HRD, homologous recombination deficiency.
See this image and copyright information in PMC

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