Name CC ID Diagnosis Report Date

Pancreatic Adenocarcinoma, Stage IV 9/13/2020

200-xxxx

Date of Birth Goals

MM/DD/YYYY Treatment options including clinical trial near home
Could potentially travel to NY or Philadelphia.
Date of Diagnosis

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MM/DD/YYYY

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Molecular Alterations
Sex
F Tempus xT 648 Genes, pancreas mass, collected 11/20/2019

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Physician KRAS G12V
Dr. Smith ARID1A P320fs
TP53 I255F
ARID1B R1624*
Institution
UCSF TMB- 2.1mut/Mb
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MSI- stable
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Short Case Summary
65-year-old female diagnosed with borderline resectable pancreatic cancer in September 2018. She
completed neoadjuvant FOLFIRINOX and underwent a Whipple resection with 4/16 LN+ (pT3N1M0).
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She received an additional 10 cycles of FOLFIRINOX. Unfortunately, in January 2020 she had recurrent
disease in her liver (confirmed by biopsy). She received 5 courses of high dose radiation and
gemcitabine plus abraxane (3/20-9/20). CT scan from 9/15/2020 shows disease progression with rising
CA 19-9. PS noted to be 1 (ECOG) on 9/23/2020.
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Disclaimer: This report does not constitute a medical treatment plan and is not a substitute for
medical advice. However, it is intended to be actionable information for you to understand,
evaluate, and discuss with your treating oncologist. 1
Name CC ID Diagnosis Report Date
Pancreatic Adenocarcinoma, Stage IV 9/13/2020
200-xxxx

VIRTUAL TUMOR BOARD SUMMARY/ADDITIONAL

CONSIDERATIONS
Summary of the discussion and consensus:
• Molecular alterations in ARID1A/B noted.

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• A clinical trial should be considered if the patient discontinues Gem/abx due to progression or
intolerant side effects.

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• Consensus to favor clinical trial with a PARP inhibitor, monotherapy or in combination with ATR
inhibitor or PD-1 inhibitor.

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Disclaimer: This report does not constitute a medical treatment plan and is not a substitute for
medical advice. However, it is intended to be actionable information for you to understand,
evaluate, and discuss with your treating oncologist. 2
 Name CC ID Diagnosis Report Date
Pancreatic Adenocarcinoma, Stage IV 9/13/2020
200-xxxx

OPTION NAME THERAPY MOLECULAR SCIENTIFIC RATIONALE

DESCRIPTION TARGET

AZD6738 alone or with Olaparib AZD6738 is an ARID1A ARID1a/ATR synthetic lethality shown
investigational (ARID1B) in vivo - decrease tumor growth of

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A clinical trial at UCSF specifically ATR inhibitor ARID1A KO xenografts treated with
looking at ARID1A (also known as ATR inhibitor.

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BAF250a) is enrolling. https://www.nature.com/articles/ncom
Olaparib is a ms13837 (see figure 3F)
https://clinicaltrials.gov/ct2/show/NCT036 PARP inhibitor
82289 Recent data shows benefit
With ATR inhibitor especially in

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patients with DDR alterations
https://ascopubs.org/doi/10.1200/J
CO.19.02404
BAY1895344 and Niraparib BAY1895344 is
an ATR kinase loss of ARID1B may amplify the
Available through a clinical trial enrolling inhibitor sensitivity of ARID1A to radiation- as
in NY and other sites. shown in colon and ovarian cancer:

https://clinicaltrials.gov/ct2/show/NCT042
67939
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Niraparib is a
PARP inhibitor https://www.nature.com/articles/s4159
8-019-54757-z

https://www.ncbi.nlm.nih.gov/pmc/arti
cles/PMC6032401/
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BAY1895344 in Combination With BAY1895344 is ARID1A Preliminary (unpublished) clinical data
Pembrolizumab an ATR kinase (ARID1B) suggest this combination may be
inhibitor beneficial for ARID1A altered cancers.
A clinical trial is enrolling in New York
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Pembrolizumab
https://clinicaltrials.gov/ct2/show/NCT040 is an antibody
95273 against PD-1

clinical-trials [email protected]
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PARP inhibitor (i.e Olaparib, ARID1A Preliminary (unpublished) clinical data

niraparib) plus anti-PD1 therapy (i.e (ARID1B) suggest this combination may be
Nivolumab, pembrolizumab) beneficial for ARID1A altered cancers.
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Off-label

Disclaimer: This report does not constitute a medical treatment plan and is not a substitute for
medical advice. However, it is intended to be actionable information for you to understand,
evaluate, and discuss with your treating oncologist. 3
Name CC ID Diagnosis Report Date
Pancreatic Adenocarcinoma, Stage IV 9/13/2020
200-xxxx

Detailed Case Summary

*Provided predominately from clinic notes and CT reports

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Date Event

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02Sep2018 EUS with biopsy confirms adenocarcinoma with squamous differentiation,
borderline resectable, no malignant cells identified of peritoneal washings.
18Sep2018 – 26Feb2019 FOLFIRINOX (neoadjuvant)
13Mar2019 Underwent Whipple surgery, pT3N1M0, 4/16 LN+, no LVI, PVI present
30Apr2019 Completed additional 10 cycles of FOLFIRINOX

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20Jan2020 CT scan reveals 2 hepatic lesions, biopsy confirms pancreatic
adenocarcinoma
15Feb2020 – 20Feb2020 SBRT radiation to larger hepatic lesion
15Mar2020 – 15Sep2020 Gemcitabine/abraxane, reduction of dose to 80% due to afebrile
neutropenia
15Sep2020 CT- abdomen and shows disease progression including a left pelvic
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sidewall fluid collection, increase in size of hepatic lesions, ascites, new
peritoneal implants. CT chest shows interval development of pleural
effusion, and new soft tissue nodularity at right base.
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Disclaimer: This report does not constitute a medical treatment plan and is not a substitute for
medical advice. However, it is intended to be actionable information for you to understand,
evaluate, and discuss with your treating oncologist. 4
Name CC ID Diagnosis Report Date
Pancreatic Adenocarcinoma, Stage IV 9/13/2020
200-xxxx

How was this report created?

Cancer Commons scientists create a comprehensive, personalized case summary after
reviewing your full medical records, including test reports, imaging scans, genomic sequencing,
molecular profile, and treatment goals. Cancer Commons scientists research therapeutic
options including investigational therapies, off-label combinations, clinical trials, and also testing

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modalities such as next generation sequencing (NGS), liquid biopsies, and organoid testing.
Research efforts are supported by learnings and insights derived from Cancer Commons’

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experience running tumor boards and working with patients like you.

If you have any questions, please contact Leslie Jared at [email protected] or

(650) 530-3636.

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Disclaimer: This report does not constitute a medical treatment plan and is not a substitute for
medical advice. However, it is intended to be actionable information for you to understand,
evaluate, and discuss with your treating oncologist. 5