Anyone have experience with olaparib or rucaparib to share?

I've spoken with a local man by phone who was treated for stage-4 PDAC with Folfirinox. He has a BRCA (didn't specify 1 or 2) germline mutation. After the Folfirinox got his CA19-9 into normal range, his doctor switched him to olaparib (Lynparza). His CA19-9 is still normal, no sign of active tumors on scans, and minimal side effects. I hope to meet him in person soon!

I was diagnosed with pancan in march 22 at 72 years old. I was determined to be brac2 as well. I had a Whipple in April 22. Then Folfirinox for 12 sessions. Ca 19-9 went down into single digits. It was never crazy high, always less than 200.

Tumor came back in 2024. Did gem-cisplatin until Nov 2024. Then switched to Lynparza. I also started Creon. I have been on them for a year now. Ca 19-9 has remained under 12. Just got back lastest scan yesterday and all continues to look good. Fatigue from being anemic and having to pay attention to what I eat but have felt good.

Would be glad to answer any other questions!

I am the longest patient in the world on Rubraca (Rucaparib) having been the first patient in the US to enroll in the first clinical trial called RucaPANC testing it in BRCA/PALB2 mutations in a metastatic setting of PDAC and PACC. This initial trial with a cohort of 19 that had done at least one regimen that contained oxaliplatin resulted in a complete response and I was allowed to remain on Rubraca under FDA approval of a compassionate use request. I am the longest former pancreatic cancer patient in the world on this PARap inhibitor and believed to be the longest of any PARPi being used in a pancreatic cancer setting. December will make 13.5 years out from my diagnosis of stage IV disease and have been declared cured since 2022.

There are a few other pancreatic cancer patients that participated in a trial,that followed mine at PennMedicine/Abramson Cancer Center headed by principal investigator Kim Reiss-Binder. Those patients are multiple years on it and there is an update coming out soon or has already been released. It may be on the Abramson Cancer Center website on the long-term following of these patients. I have been on Rubraca over 11 years and did one dose reduction after being on it six years when I experienced anemia. It is well managed and instead of doing a further dose reduction, a pause of one cycle is done that results in affected parameters improving. I went 12 months since the prior pause for a rent one. My hematology parameters are monitored every six weeks and although I was not feeling any affects from the anemia, it was agreed to do this recent pause as I was going hiking in the Swiss Alps at an elevation between 6500-7500 feet. I was on the pause during the trip and my parameters had quickly rebounded.

Being the longest patient in the world on a PARPi in the setting of pancreatic cancer, oncologists didn’t know what to do with my case. There was no one ahead of me to guide making a decision, so it was left up to me whether to continue maintenance monotherapy. I receive the PARPi gratis as I am considered in a phase IV portion of long-term post-trial following, tolerate it very well and have a slight increased risk of developing a new primary cancer of either pancreatic, prostate and male breast cancer. For those reasons I have decided to remain on monotherapy at this time and all the pancreatic cancer oncologists that are colleagues through the ECOG-ACRIN GI cancers committee or other national oncology groups have strongly endorsed my decision and said they would do the same if in this position.

As a side note of interest: the icon of this post is from a hike in the central alps of Switzerland in 2013 between cycles 12 and 13 of full-dose Folfirinox that led to cure.I did 24 months of chemo and of the 46 cycles, 24 were full-dose with oxaliplatin that is credited with leading to cure.

I have Acanar pan can with Mets to liver. Distal pancrtectomy and spleen removal in Sept 2023 I was on Lynparza for 4 months following 12 rounds of gem/cis. CT scan after 4 months showed new growth went back to gem/cis then to folfionox 5fu. I am currently on gemcitbine and abraxene.

Good feedback thanks gsterle. Were you radiologically clear after gemcis? Hoping you can beat it back. My gemcis is pushing it back but not clear yet. Thinking rucaparib could be better but costs a heck of a lot