How would you approach a locally advanced ampullary carcinoma with BRCA1 mutation whose Whipple showed complete pathologic response after 5 cycles of neoadjuvant mFOLFIRINOX?

Patient refuses further mFOLFIRINOX but may be open to less aggressive regimens. Is there any role for PARP inhibitors?

Medical Oncologist

I assume this patient has pancreaticobiliary-type ampullary cancer. Unfortunately, no data to support adjuvant PARP agent. With BRACA positive status, one could complete the total of six months of treatment with gem/abraxane/cisplatin.

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How would you approach a locally advanced ampullary carcinoma with BRCA1 mutation whose Whipple showed complete pathologic response after 5 cycles of neoadjuvant mFOLFIRINOX?

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