{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T07:10:38Z","timestamp":1783667438177,"version":"3.55.0"},"reference-count":38,"publisher":"Elsevier BV","issue":"7","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"funder":[{"DOI":"10.13039\/501100005010","name":"Associazione Italiana per la Ricerca sul Cancro","doi-asserted-by":"publisher","award":["22737"],"award-info":[{"award-number":["22737"]}],"id":[{"id":"10.13039\/501100005010","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.fr","clinicalkey.jp","clinicalkey.es","clinicalkey.com.au","clinicalkey.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Pancreatology"],"published-print":{"date-parts":[[2024,11]]},"DOI":"10.1016\/j.pan.2024.09.006","type":"journal-article","created":{"date-parts":[[2024,9,12]],"date-time":"2024-09-12T12:40:31Z","timestamp":1726144831000},"page":"1066-1072","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["A pilot study of chlorambucil in pre-treated metastatic pancreatic adenocarcinoma patients bearing germline BRCA or other DNA damage repair system variants"],"prefix":"10.1016","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3374-4220","authenticated-orcid":false,"given":"Catia","family":"Carconi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7719-8428","authenticated-orcid":false,"given":"Carlo","family":"Bosi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Scartozzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimiliano","family":"Cergnul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marika","family":"Cinausero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3689-3085","authenticated-orcid":false,"given":"Luca","family":"Faloppi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Garajova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7593-8138","authenticated-orcid":false,"given":"Sara","family":"Lonardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Pecora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Pisanu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2589-2415","authenticated-orcid":false,"given":"Rosella","family":"Spadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6955-7139","authenticated-orcid":false,"given":"Andrea","family":"Spallanzani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Peretti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Macchini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Orsi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6463-0293","authenticated-orcid":false,"given":"Michele","family":"Reni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.pan.2024.09.006_bib1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21654","article-title":"Cancer statistics, 2021","volume":"71","author":"Siegel","year":"2021","journal-title":"CA A Cancer J Clin"},{"key":"10.1016\/j.pan.2024.09.006_bib2","doi-asserted-by":"crossref","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA A Cancer J Clin"},{"key":"10.1016\/j.pan.2024.09.006_bib3","doi-asserted-by":"crossref","first-page":"1817","DOI":"10.1056\/NEJMoa1011923","article-title":"FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer","volume":"364","author":"Conroy","year":"2011","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.pan.2024.09.006_bib4","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1056\/NEJMoa1304369","article-title":"Increased survival in pancreatic cancer with nab-paclitaxel plus gemcitabine","volume":"369","author":"Von Hoff","year":"2013","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.pan.2024.09.006_bib5","doi-asserted-by":"crossref","first-page":"2423","DOI":"10.1200\/JCO.2013.53.6995","article-title":"Second-line oxaliplatin, folinic acid, and fluorouracil versus folinic acid and fluorouracil alone for gemcitabine-refractory pancreatic cancer: outcomes from the CONKO-003 trial","volume":"32","author":"Oettle","year":"2014","journal-title":"J\u00a0Clin Oncol"},{"key":"10.1016\/j.pan.2024.09.006_bib6","doi-asserted-by":"crossref","first-page":"3914","DOI":"10.1200\/JCO.2016.68.5776","article-title":"PANCREOX: a randomized phase III study of fluorouracil\/leucovorin with or without oxaliplatin for second-line advanced pancreatic cancer in patients who have received gemcitabine-based chemotherapy","volume":"34","author":"Gill","year":"2016","journal-title":"J\u00a0Clin Oncol"},{"key":"10.1016\/j.pan.2024.09.006_bib7","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/S0140-6736(15)00986-1","article-title":"Nanoliposomal irinotecan with fluorouracil and folinic acid in metastatic pancreatic cancer after previous gemcitabine-based therapy (NAPOLI-1): a global, randomised, open-label, phase 3 trial","volume":"387","author":"Wang-Gillam","year":"2016","journal-title":"Lancet"},{"key":"10.1016\/j.pan.2024.09.006_bib8","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1038\/nature14169","article-title":"Whole genomes redefine the mutational landscape of pancreatic cancer","volume":"518","author":"Waddell","year":"2015","journal-title":"Nature"},{"key":"10.1016\/j.pan.2024.09.006_bib9","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1038\/nature16965","article-title":"Genomic analyses identify molecular subtypes of pancreatic cancer","volume":"531","author":"Bailey","year":"2016","journal-title":"Nature"},{"key":"10.1016\/j.pan.2024.09.006_bib10","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1053\/j.gastro.2014.11.042","article-title":"Prevalence of germline mutations in cancer predisposition genes in patients with pancreatic cancer","volume":"148","author":"Grant","year":"2015","journal-title":"Gastroenterology"},{"key":"10.1016\/j.pan.2024.09.006_bib11","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1001\/jamaoncol.2021.3701","article-title":"Risk of pancreatic cancer among individuals with pathogenic variants in the ATM gene","volume":"7","author":"Hsu","year":"2021","journal-title":"JAMA Oncol"},{"key":"10.1016\/j.pan.2024.09.006_bib12","doi-asserted-by":"crossref","first-page":"4447","DOI":"10.3390\/cancers14184447","article-title":"Clinical significance of germline pathogenic variants among 51 cancer predisposition genes in an unselected cohort of Italian pancreatic cancer patients","volume":"14","author":"Puccini","year":"2022","journal-title":"Cancers"},{"key":"10.1016\/j.pan.2024.09.006_bib13","doi-asserted-by":"crossref","DOI":"10.1016\/j.ctrv.2021.102262","article-title":"Treatment opportunities and future perspectives for pancreatic cancer patients with germline BRCA1-2 pathogenic variants","volume":"100","author":"Macchini","year":"2021","journal-title":"Cancer Treat Rev"},{"key":"10.1016\/j.pan.2024.09.006_bib14","doi-asserted-by":"crossref","first-page":"630","DOI":"10.1016\/j.jamcollsurg.2017.12.021","article-title":"BRCA1\/BRCA2 germline mutation carriers and sporadic pancreatic ductal adenocarcinoma","volume":"226","author":"Blair","year":"2018","journal-title":"J\u00a0Am Coll Surg"},{"key":"10.1016\/j.pan.2024.09.006_bib15","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1007\/s00280-023-04585-w","article-title":"Clinical outcomes and response to chemotherapy in a cohort of pancreatic cancer patients with germline variants of unknown significance (VUS) in BRCA1 and BRCA2 genes","volume":"92","author":"Militello","year":"2023","journal-title":"Cancer Chemother Pharmacol"},{"key":"10.1016\/j.pan.2024.09.006_bib16","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1002\/path.4140","article-title":"Secondary mutations in <scp>BRCA2<\/scp> associated with clinical resistance to a <scp>PARP<\/scp> inhibitor","volume":"229","author":"Barber","year":"2013","journal-title":"J\u00a0Pathol"},{"key":"10.1016\/j.pan.2024.09.006_bib17","doi-asserted-by":"crossref","first-page":"4259","DOI":"10.3390\/cancers13174259","article-title":"Targeting DNA damage repair mechanisms in pancreas cancer","volume":"13","author":"Perkhofer","year":"2021","journal-title":"Cancers"},{"key":"10.1016\/j.pan.2024.09.006_bib18","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1038\/s41416-022-02086-w","article-title":"Second-line therapy in pancreatic ductal adenocarcinoma (PDAC) patients with germline BRCA1-2 pathogenic variants (gBRCA1-2pv)","volume":"128","author":"Orsi","year":"2023","journal-title":"Br J Cancer"},{"key":"10.1016\/j.pan.2024.09.006_bib19","doi-asserted-by":"crossref","DOI":"10.1016\/j.esmoop.2021.100238","article-title":"Chemotherapy toxicity and activity in patients with pancreatic ductal adenocarcinoma and germline BRCA1-2 pathogenic variants (gBRCA1-2pv): a multicenter survey","volume":"6","author":"Orsi","year":"2021","journal-title":"ESMO Open"},{"key":"10.1016\/j.pan.2024.09.006_bib20","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1056\/NEJMoa1903387","article-title":"Maintenance Olaparib for germline BRCA -mutated metastatic pancreatic cancer","volume":"381","author":"Golan","year":"2019","journal-title":"N\u00a0Engl J Med"},{"key":"10.1016\/j.pan.2024.09.006_bib21","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1038\/s41416-019-0582-7","article-title":"Platinum response characteristics of patients with pancreatic ductal adenocarcinoma and a germline BRCA1, BRCA2 or PALB2 mutation","volume":"122","author":"Wattenberg","year":"2020","journal-title":"Br J Cancer"},{"key":"10.1016\/j.pan.2024.09.006_bib22","doi-asserted-by":"crossref","first-page":"6684","DOI":"10.3390\/ijms21186684","article-title":"Inhibition of DNA repair in cancer therapy: toward a multi-target approach","volume":"21","author":"Lodovichi","year":"2020","journal-title":"Int J Mol Sci"},{"key":"10.1016\/j.pan.2024.09.006_bib23","doi-asserted-by":"crossref","DOI":"10.15252\/emmm.201809982","article-title":"Chlorambucil targets <scp>BRCA<\/scp> 1\/2-deficient tumours and counteracts <scp>PARP<\/scp> inhibitor resistance","volume":"11","author":"Tacconi","year":"2019","journal-title":"EMBO Mol Med"},{"key":"10.1016\/j.pan.2024.09.006_bib24","doi-asserted-by":"crossref","first-page":"852","DOI":"10.3109\/10428194.2015.1085528","article-title":"Systematic review of the recent evidence for the efficacy and safety of chlorambucil in the treatment of B-cell malignancies","volume":"57","author":"Lepretre","year":"2016","journal-title":"Leuk Lymphoma"},{"key":"10.1016\/j.pan.2024.09.006_bib25","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.annonc.2020.09.019","article-title":"Chronic lymphocytic leukaemia: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"32","author":"Eichhorst","year":"2021","journal-title":"Ann Oncol"},{"key":"10.1016\/j.pan.2024.09.006_bib26","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.canlet.2021.11.021","article-title":"Molecular tests for prediction of tumor sensitivity to cytotoxic drugs","volume":"526","author":"Imyanitov","year":"2022","journal-title":"Cancer Lett"},{"key":"10.1016\/j.pan.2024.09.006_bib27","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1)","volume":"45","author":"Eisenhauer","year":"2009","journal-title":"Eur J Cancer"},{"key":"10.1016\/j.pan.2024.09.006_bib28","doi-asserted-by":"crossref","first-page":"2630","DOI":"10.1002\/cncr.24302","article-title":"Carbohydrate antigen 19-9 change during chemotherapy for advanced pancreatic adenocarcinoma","volume":"115","author":"Reni","year":"2009","journal-title":"Cancer"},{"key":"10.1016\/j.pan.2024.09.006_bib29","unstructured":"https:\/\/ctep.cancer.gov\/protocoldevelopment\/electronic_applications\/docs\/CTCAE_v5_Quick_Reference_8.5x11.pdf."},{"key":"10.1016\/j.pan.2024.09.006_bib30","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1038\/bjc.2014.418","article-title":"Overall survival and clinical characteristics of pancreatic cancer in BRCA mutation carriers","volume":"111","author":"Golan","year":"2014","journal-title":"Br J Cancer"},{"key":"10.1016\/j.pan.2024.09.006_bib31","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.ejca.2017.11.004","article-title":"Phase II trial of veliparib in patients with previously treated BRCA-mutated pancreas ductal adenocarcinoma","volume":"89","author":"Lowery","year":"2018","journal-title":"Eur J Cancer"},{"key":"10.1016\/j.pan.2024.09.006_bib32","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1016\/j.annonc.2022.05.519","article-title":"Pembrolizumab in microsatellite instability high or mismatch repair deficient cancers: updated analysis from the phase II KEYNOTE-158 study","volume":"33","author":"Maio","year":"2022","journal-title":"Ann Oncol"},{"key":"10.1016\/j.pan.2024.09.006_bib33","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1200\/JCO.2014.56.2728","article-title":"Olaparib monotherapy in patients with advanced cancer and a germline BRCA1\/2 mutation","volume":"33","author":"Kaufman","year":"2015","journal-title":"J\u00a0Clin Oncol"},{"key":"10.1016\/j.pan.2024.09.006_bib34","doi-asserted-by":"crossref","DOI":"10.1016\/j.esmoop.2020.100032","article-title":"Germinal BRCA1-2 pathogenic variants (gBRCA1-2pv) and pancreatic cancer: epidemiology of an Italian patient cohort","volume":"6","author":"Peretti","year":"2021","journal-title":"ESMO Open"},{"key":"10.1016\/j.pan.2024.09.006_bib35","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1007\/s11864-021-00895-4","article-title":"Systemic therapy for metastatic pancreatic cancer","volume":"22","author":"Ettrich","year":"2021","journal-title":"Curr Treat Options Oncol"},{"key":"10.1016\/j.pan.2024.09.006_bib36","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1038\/nature06633","article-title":"Secondary mutations as a mechanism of cisplatin resistance in BRCA2-mutated cancers","volume":"451","author":"Sakai","year":"2008","journal-title":"Nature"},{"key":"10.1016\/j.pan.2024.09.006_bib37","doi-asserted-by":"crossref","first-page":"2581","DOI":"10.1158\/0008-5472.CAN-08-0088","article-title":"Secondary BRCA1 mutations in BRCA1 -mutated ovarian carcinomas with platinum resistance","volume":"68","author":"Swisher","year":"2008","journal-title":"Cancer Res"},{"key":"10.1016\/j.pan.2024.09.006_bib38","doi-asserted-by":"crossref","first-page":"1826","DOI":"10.1158\/2159-8290.CD-22-0412","article-title":"Spectrum of response to platinum and PARP inhibitors in germline BRCA \u2013associated pancreatic cancer in the clinical and preclinical setting","volume":"13","author":"Stossel","year":"2023","journal-title":"Cancer Discov"}],"container-title":["Pancreatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1424390324007361?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1424390324007361?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2024,11,9]],"date-time":"2024-11-09T15:35:32Z","timestamp":1731166532000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1424390324007361"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11]]},"references-count":38,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["S1424390324007361"],"URL":"https:\/\/doi.org\/10.1016\/j.pan.2024.09.006","relation":{},"ISSN":["1424-3903"],"issn-type":[{"value":"1424-3903","type":"print"}],"subject":[],"published":{"date-parts":[[2024,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"A pilot study of chlorambucil in pre-treated metastatic pancreatic adenocarcinoma patients bearing germline BRCA or other DNA damage repair system variants","name":"articletitle","label":"Article Title"},{"value":"Pancreatology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.pan.2024.09.006","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2024 IAP and EPC. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}