Posted: Thursday, May 25, 2023
Sherise C. Rogers, MD, MPH, of the University of Florida College of Medicine, Gainesville, and colleagues analyzed the genetic and pharmacogenetic differences in targeted and cytotoxic therapies for Black individuals diagnosed with pancreatic ductal adenocarcinoma. Their findings, published in the Journal of the National Medical Association, suggested that the genetic profiles of these patients may contribute to disparities related to chemotherapeutic response.
“Improving the sample sizes of African Americans and other minorities in biorepositories can lead to a greater understanding of pharmacogenetic differences and achieve an equitable distribution of care and outcomes for patients with pancreatic ductal adenocarcinoma,” stated the study authors.
This retrospective study focused on articles pertaining to therapeutic strategies for pancreatic ductal adenocarcinoma published from 1995 to 2022 containing participant pharmacokinetic and pharmacogenetic data. The main objective was to identify genes that interfere with the drug metabolism of U.S. Food and Drug Administration (FDA)-approved drugs.
Clinical trials of the NTRK inhibitors entrectinib and larotrectinib yielded objective response rates of 57% and 79%, respectively, with median durations of response of 10.4 and 35.2 months. Although extremely rare in Black patients with pancreatic cancer, the expression level of genes NTRK1, NTRK2, and NTRK3 does not seem to be significantly correlated with overall survival, according to the study authors.
Although few patients in these pivotal clinical trials had pancreatic ductal adenocarcinoma, two treated with entrectinib and one treated with larotrectinib achieved a partial response. Despite the rarity of these NTRK gene fusions in this patient population, the investigators suggested performing testing for NTRK fusion genes on all patients with this type of aggressive pancreatic cancer to ensure proper treatment.
Disclosure: For full disclosures of the study authors, visit sciencedirect.com.
Journal of the National Medical Association