# Phase II study of maintenance rucaparib in patients with platinum-sensitive advanced pancreatic cancer and a pathogenic germline or somatic variant in BRCA1, BRCA2, or PALB2

Source: https://onco.cc/key-papers/paper-reiss-rucaparib-maintenance-brca-palb2-pancreatic-jco-2021/  
OnCo record `paper-reiss-rucaparib-maintenance-brca-palb2-pancreatic-jco-2021` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Rucaparib maintenance after platinum chemotherapy kept 60% of 42 patients progression-free at six months, with responses in germline BRCA2, germline PALB2 and somatic BRCA2 carriers, widening the group PARP inhibitors may help beyond POLO's germline BRCA rule.

## Summary

Investigator-initiated single-arm phase 2: advanced pancreatic cancer with a germline or somatic pathogenic variant in BRCA1, BRCA2 or PALB2 after at least 16 weeks of platinum without resistance; chemotherapy stopped and rucaparib 600 mg twice daily given until progression. Of 46 enrolled, 42 were evaluable (27 gBRCA2, 7 gBRCA1, 6 gPALB2, 2 sBRCA2). Progression-free survival at 6 months was 59.5%, median 13.1 months; median overall survival 23.5 months; 12-month progression-free survival 54.8%. Response in 36 measurable patients was 41.7% (3 complete), disease control 66.7%, median duration 17.3 months; responses in gBRCA2 (11 of 27), gPALB2 (3 of 6) and sBRCA2 (1 of 2).

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Journal: Journal of Clinical Oncology
- Year: 2021
- DOI: 10.1200/JCO.21.00003
- Authors: Reiss KA, Mick R, O'Hara MH, et al.
- Findings: Six-month progression-free survival 59.5%, median 13.1 months; overall survival 23.5 months.; Response 41.7%; gPALB2 3 of 6 and sBRCA2 1 of 2 responded.
- What it means: It is the evidence that PALB2 and somatic BRCA2 belong in the PARP inhibitor conversation even though the olaparib label stops at germline BRCA.
- Caveats: Single-arm, 42 evaluable, platinum-sensitive selection.; Rucaparib has no pancreatic approval.

## Sources

- Reiss et al., J Clin Oncol 2021: maintenance rucaparib in 42 BRCA1, BRCA2 or PALB2 patients: https://doi.org/10.1200/JCO.21.00003
- PubMed: https://pubmed.ncbi.nlm.nih.gov/33970687/

## Connected records

- biomarkers: [Germline BRCA1/2 pathogenic variant (gBRCAm)](https://onco.cc/biomarkers/brca-germline/), [Tumour (somatic or germline) BRCA1/2 mutation and HRR gene alterations](https://onco.cc/biomarkers/brca-somatic/)
- cancers: [BRCA or PALB2-mutant pancreatic ductal adenocarcinoma](https://onco.cc/cancers/brca-palb2-pdac/), [Metastatic pancreatic ductal adenocarcinoma](https://onco.cc/cancers/metastatic-pdac/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- targets: [BRCA1 / BRCA2 (HRD)](https://onco.cc/targets/brca/), [PALB2](https://onco.cc/targets/palb2/)
- drugs: [Rucaparib](https://onco.cc/drugs/rucaparib/)
- institutions: [Abramson Cancer Center, University of Pennsylvania](https://onco.cc/institutions/penn-abramson/)
- terms: [Germline vs somatic mutations](https://onco.cc/terms/germline-vs-somatic/), [Synthetic lethality](https://onco.cc/terms/synthetic-lethality/)
- people: [Robert H. Vonderheide](https://onco.cc/people/robert-vonderheide/)
- journals: [Journal of Clinical Oncology](https://onco.cc/journals/jco/)

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