Howard Hochster, MD, FACP, discusses results from the SWOG S1513 study, which examined the use of second-line modified FOLFIRI with PARP inhibitor ABT-888 (Veliparib) versus solely FOLFIRI in metastatic pancreatic cancer.
Howard Hochster, MD, FACP, associate director for clinical research and director, Gastrointestinal Oncology, Rutgers Cancer Institute of New Jersey, director of oncology research, RWJBarnabas Health, discussed results from the SWOG S1513 study, which examined the use of second-line modified FOLFIRI with the PARP inhibitor ABT-888 (Veliparib) versus FOLFIRI alone in metastatic pancreatic cancer.
For the study, 123 patients were accepted. Of these patients, 108 were included in the analysis and 117 were biomarker evaluable. The most common grade 3/4 treatment-related adverse events for veliparib and FOLFIRI versus FOLFIRI alone were neutropenia (33% vs 20%), fatigue (19% vs 4%), and nausea (11% vs 4%). Median overall survival (OS) for the combination versus FOLFIRI alone was 5.1 months and 5.9 months, and the median progression-free survival was 2.1 months versus 2.9 months.
Nearly 30% of patients in the trial had DNA repair gene abnormalities; however, veliparib increased toxicity and did not improve OS when combined with FOLFIRI in biomarker unselected patients. In the future, BRCA1/2 and DNA damage-response biomarkers will be correlated with efficacy to inform patient selection for PARP inhibitor clinical trials.