Molecular analysis in pancreatic adenocarcinoma: a real-world study from high-volume French centres (CAPANCOBIO study)

Abstract

Background

In pancreatic adenocarcinoma (PA) it is crucial to better understand the molecular biology and identify targetable molecular alterations to obtain therapeutic improvements.

Methods

The aim of the CAPANCOBIO study was to assess routine clinical practice regarding tumour somatic molecular analysis (SMA) in patients with unresectable PA. Tumour SMAs for patients with advanced PA were collected in nine high-volume French centres from September 2019 to October 2021 to identify factors influencing the prescription of SMA.

Results

Among the 397 patients included in the CAPANCOBIO study, 70 had an SMA (17.6%). The most frequent tests were next-generation sequencing analysis (70.0%). Among the 70 patients with SMA, 31 (44.3%) had at least one alteration detected, but only 6 patients had targetable alterations. Among these, only one patient (n = 1/6, 16.6%) was included in a clinical trial. Patients with SMA were younger (P < 0.0001), more often female (P = 0.007), and more frequently had a family history of the BRCA cancer spectrum (P = 0.017).

Conclusions

Few patients with advanced PA had SMA of the tumour. Despite patients with targetable molecular alterations identified, very few patients were treated with targeted therapy and/or included in a clinical trial. It is essential to increase SMA for advanced PA in routine clinical practice to increase the use of targeted therapy and inclusions in clinical trials.