Cure for my stage IV disease occurred as a result of doing 46 cycles of chemotherapy dosed in alternating groups of six starting with full dose Folfirinox of the original formulation used from FDA approval in 2011 to 2018 when (m)Folfirinox was FDA approved and 20% less concentrated in one of more of its components.

The clinical trial drug I am on is a PARPi inhibitor. The intent of the trial is to use it for maintenance monotherapy by recurrence and preventing a new primary cancer from forming. Patients with germline BRCa mutations have a an elevated lifetime risk of developing a new primary tumor in the pancreas-whether resected or not. There is also risk in this cohort of developing prostate and male breast cancer and ovarian and breast cancers in women.

The PARPi inhibitor is Rubraca (Rucaparib) and it is very much available for the cancers it has been FDA approved for. The company did not have sufficient funding to peruse approval from the FDA for pancreatic cancer and what factored into that decision in not perusing approval was the fact of the market share of a tiny market already held by market leader Lynparza manufactured by Astra Zeneca. The small Biopharma that developed Rubraca saw their Return on Investment would not make sense and instead pursued approvals for breast and prostate cancers. It did receive approval for prostate cancer driven by BRCa mutations.

Rubraca (Rucaparib) can be obtained with FDA approval when patients experience adverse events/side effects on Lynparza (Olaparib) or Zajula (Nariparib). I know of such a patient that was recently switched to Rubraca within the past three weeks to see if she can tolerate it better. I am also aware of a woman prescribed Rubraca for her PALB2 germline mutation and is around 5 years being successfully treated.