Radiation-Induced Colitis in a Pancreatic Cancer Patient With a Germline BRCA2 Mutation: A Case Report.

Abstract Borderline resectable pancreatic cancer (BRPC) is increasingly treated with neoadjuvant chemotherapy and chemoradiation (CRT). Gastrointestinal (GI) toxicities are a main concern when designing radiation treatment plans for BRPC. BRCA1 and 2 deleterious mutations result in increased risks of several cancers including pancreatic cancer. There is also concern whether patients with germline BRCA1/2 mutations are at increased risk for normal tissue toxicities following radiation, due to defects in DNA repair. We present a case report of a patient with a deleterious germline BRCA2 mutation who developed BRPC. He was initiated on neoadjuvant CRT and developed acute colitis during his radiation course. His radiation ultimately had to be discontinued due to worsening GI symptoms, reduced performance status, and prolonged hospitalization. The toxicity he experienced required an unusual discontinuation of therapy which we donu0027t normally do for these patients. We will present the background of the case and review the literature of BRCA1/2 mutations and correlations with radiation-induced side effects.