cancers Review BRCA in Gastrointestinal Cancers: Current Treatments and Future Perspectives Eleonora Molinaro, Kalliopi Andrikou, Andrea Casadei-Gardini * and Giulia Rovesti Department of Oncology and Hematology, Division of Oncology, University of Modena and Reggio Emilia, 41121 Modena, Italy;
[email protected] (E.M.);
[email protected] (K.A.);
[email protected] (G.R.) * Correspondence:
[email protected] Received: 10 October 2020; Accepted: 11 November 2020; Published: 12 November 2020 Simple Summary: BRCA gene mutations are progressively gaining more attention in the context of gastrointestinal malignancies, especially in pancreatic cancer where their identification can have both therapeutic and surveillance relevance. Abstract: A strong association between pancreatic cancer and BRCA1 and BRCA2 mutations is documented. Based on promising results of breast and ovarian cancers, several clinical trials with poly (ADP-ribose) polymerase inhibitors (PARPi) are ongoing for gastrointestinal (GI) malignancies, especially for pancreatic cancer. Indeed, the POLO trial results provide promising and awaited changes for the pancreatic cancer therapeutic landscape. Contrariwise, for other gastrointestinal tumors, the rationale is currently only alleged. The role of BRCA mutation in gastrointestinal cancers is the subject of this review. In particular, we aim to provide the latest updates about novel therapeutic strategies that, exploiting DNA repair defects, promise to shape the future therapeutic scenario of GI cancers. Keywords: BRCA1; BRCA2; gastrointestinal cancers; HRD; pancreatic cancer; Olaparib; PARP inhibitors; surveillance 1. Introduction BRCA1 and BRCA2 are famous tumor susceptibility genes. They encode for proteins playing a crucial role in the correct repair of damaged DNA. Indeed, these genes are key components of the homologous recombination (HR) pathway [1].