It might be in a maintenance setting rather than as a treatment, but Lynparza’s hit in the Polo trial represents a rare success in pancreatic cancer, a disease against which virtually everything fails. It also marks another milestone for the resurgent Parp inhibitor class, though there is practically no industry involvement in pancreatic cancer on the part of competing Parp inhibitor developers. The scientific rationale here appears to be backed by the fact that 3-5% of pancreatic cancer patients carry a Brca mutation, and if related genes are included the rate rises to 17%. In the treatment setting Clovis’s Rubraca yielded a 16% remission rate in second or third-line Brca-mutants, but the company does not appear to be pursuing this indication. Astrazeneca/Merck & Co’s Lynparza, meanwhile, is approved in various ovarian and breast cancer settings, but the sellside has not paid much attention to pancreatic cancer, and most analysts do not ascribe significant revenue forecasts to it. Astra says it will now discuss the Polo progression-free survival data with regulators, but the lack of sellside interest suggests that most had seen pancreatic cancer as a shot to nothing.
|Selected studies of Parp inhibitors in pancreatic cancer|
|Project||Primary sponsor||Setting||Genetic criteria||Trial ID|
|Lynparza||Astrazeneca/Merck & Co||1st-line maintenance||gBrca 1/2 mut||Polo (NCT02184195)|
|Rubraca||Uni of Pennsylvania||1st or 2nd-line maintenance||Brca 1/2 or Palb2 mut||NCT03140670|
|Zejula||Dana-Farber||≥2nd-line treatment||Brca 1/2, Palb2, Chek2 or ATM mut||NCT03601923|
|Talazoparib||NCI||≥2nd-line treatment||Brca 1/2 mut||NCT01989546|