2009 - Efficacy of platinum-containing chemotherapy and prognosis of pancreatic cancer patients with homologous recombination deficiency: meta-analysis of published clinical studies

Background

The aim of our study was to determine the effect of homologous recombination gene deficiency (HRD) on the effectiveness of platinum chemotherapy and prognosis in patients with pancreatic cancer (PC).

Methods

PubMed and EMBASE database were processed. The search criteria included articles and abstracts till 16.01.2019. Primary outcome was hazard ratio (HR) for overall survival (OS) and 95% confidence interval (CI). Meta-analysis was conducted by «Review Manager» (RevMan) Ver. 5.3.

Results

The request identified 7038 records. A total of 4 studies were included in the meta-analysis and 16 in the systematic review. By the meta-analysis data HRD genotype didn’t affect the prognosis in resectable PC (HR = 1.03, 95% CI 0.46-2.33). By the systemic review average weighted median (AWM) OS for patients with HRD (n = 183) was 34.6 versus 27 months in patients without HRD (n = 1079). For patients who received platinum-based chemotherapy AWM OS was 46.1 months in group with HRD (n = 74) and 36.3 without the HRD (n = 227). For platinum-naive subgroup AWM OS was 24.2 months in HRD (n = 44) and 42.9 in non HRD patients (n = 134). The administration of platinum was associated with more favorable prognosis in HRD patients with resectable PC, but the differences weren`t statistically significant (HR = 0.60, 95% CI 0.36-1.33). For patients with advanced PC AWM OS was 19.8 months in group with HRD (n = 312) versus 15.6 months without HRD (n = 977). In subgroup with platinum, AWM OS was 23.8 and 17.1 months favoring HRD genotype. In subgroup without platinum, AWM OS was 8.3 months vs 12.0 months favoring HRD genotype.

Conclusions

HRD genotype is associated with poor prognosis. But administration of platinum-based chemotherapy can significantly improve the outcome in such a population of pts.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

This research is conducted under the auspices of the experimental governmental assignment of the Ministry of Health of the Russian Federation and coordinated by the FSBI “Centre for Strategic Planning and Management of Biomedical Health Risks” of the Ministry of Health of the Russian Federation.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.