Would you consider using a PARP inhibitor in a patient with metastatic pancreatic cancer with a germline ATM mutation after progression on FOLFIRINOX and gemcitabine based chemotherapy?

I would not use a PARP inhibitor in this situation. The available evidence on PARP inhibitors in pancreatic cancer is in the first-line maintenance setting, among patients with germline BRCA mutations (and now also among patients with somatic BRCA mutations and with germline PALB2 mutations). So cur...

I would not.

In addition to the nice explanation above, MSKCC led a small trial in a similar population with dismal response to PARPi. Lowery et al., PMID 29223478

12 out of 16 patients had PD as their best documented response. PFS was 1.7 months.