A New Triple Combination for Tumors with BRCA1/2 or PALB2 Mutations

Larry Ostby; National Cancer Institute

Could adding cisplatin to nab-paclitaxel and gemcitabine be an effective treatment for pancreatic cancer patients with certain mutations whose initial treatment has stopped working?

The combination of the chemotherapy drugs gemcitabine and nab-paclitaxel is one of the standard treatments for metastatic pancreatic cancer. Because platinum-based drugs have been shown to be more effective in patients with BRCA1/2 mutations, nab-paclitaxel is often being replaced with cisplatin.

Researchers are now testing whether a combination of all three drugs will produce an even better response for pancreatic cancer patients with BRCA1/2 or PALB2 genetic mutations.

Comparing Combinations

The phase II/III clinical trial compares the effect of the three-drug chemotherapy combination of nab-paclitaxel, gemcitabine, and cisplatin (dubbed NABPLAGEM) versus the standard two-drug chemotherapy combination of nab-paclitaxel plus gemcitabine in patients with metastatic pancreatic cancer and a known BRCA1, BRCA2, or PALB2 mutation.

Patients are randomly assigned to one of two arms. Those in the NABPLAGEM arm receive the three-drug combination, while the patients in the other arm receive the standard nab-paclitaxel/gemcitabine combination.

Researchers will be evaluating and comparing overall response rate, overall survival, progression-free survival, and any adverse effects of the different drug combinations.

Joining the Trial

The trial is open in multiple locations around the U.S. To participate patients must have metastatic pancreatic cancer and either a BRCA1/2 or PALB2 mutation. Participants may have undergone prior treatment but must not have had cisplatin previously.

We encourage you to consult your physicians for clinical trials that may be right for you. The website ClinicalTrials.gov provides more details about this trial as well as many others. You can visit the EmergingMed Trial Finder for a list of all active pancreatic cancer clinical trials.

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