@ncteacher ,

Since we share the ATM mutation, I'll send you a direct message with some trials that were proposed / recommended for me.

My primary oncologist was not impressed with the study results of PARP inhibitors on BRCA-mutated tumors, and perceived less applicability for PARP-i on ATM-mutated tumors.

The more directed research for ATM mutations seems to be focused on ATR inhibitors.

In both cases, I think the intent is to prevent the cancer cells from figuring out how to repair their own DNA in order to survive.

I'm not aware (yet) of studies that pair an ATR inhibitor with a conventional cytotoxic chemo like Folfirinox or Gem/Abrax/Cis. Knowing that the latter (GAC) is doing a decent job controlling my current disease, presumably damaging some DNA in the process, I would like to pile an ATR inhibitor on top of that, but apparently can't. One researcher I spoke with suggested his belief that an ATR inhibitor he was studying did double duty (damaging DNA as well as preventing repair) so that might offer some relief from treatment overload.

I've also read (but didn't save the links) that ATR inhibitors may also help reverse the platinum resistance that patients (ATM-mutated in particular) eventually develop on that therapy, so there might be hope for combining the two (legally in the USA) as a more aggressive therapy in the future.

I can't remember if a similar response (reversing platinum resistance) was suspected for PARP inhibitors in BRCA-mutated patients, but it's worth researching for those affected. My brain was full before chemo-brain settled in on top of that, so I apologize for not having more details.

I hope this helps a little.

--mm

My MD has not discussed any maintenance possibilities for me at this time. My cancer is wrapped around one vein- they are thinking they could possibly remake a section of vein if needed, during the Whipple.

They told me if the cancer was wrapped around an artery, I would not be able to have surgery.