Prognostic Value of Plasma Circulating Tumor (ct) DNA KRAS Mutations and Serum CA19-9 in Unresectable Pancreatic Cancer (PC) Patients



The overall survival (OS) time of patients with unresectable pancreatic cancer (PC) varies widely. Diagnostic tools are presently lacking to predict patient outcome.
The vast majority of pancreatic tumors harbor KRAS mutations, which can be detected in circulating tumor (ct)DNA.

Clinical Study Design

  • Patient demographics: 84 females and 92 males, median age 68, range 45-89 years.
  • Locally advanced (n=50) or metastatic (n=132) pancreatic cancer.
  • Palliative treatment with gemcitabine or FOLFIRINOX.

Highlighted Tables and Graphs

Association Between Baseline ctDNA KRAS G12/13 and Overall Survival

Combination of Baseline ctDNA KRAS G12/13 and CA-19-9 is a More Powerful Predictor of OS

Monitoring ctDNA KRAS Burden on Chemotherapy


  • In a study of 182 patients with locally advanced or metastatic pancreatic cancer, a statistically significant negative association was found between baseline ctDNA KRAS counts and OS (p < 0.0001). A combination of ctDNA KRAS and CA 19-9 was a more powerful predictor of OS than either marker alone and allowed identification of a group of patients (17%) with significantly greater overall survival.
  • Use of the time-dependent model for monitoring patients beyond baseline allows more accurate assessment of responsiveness to therapy and associated increase or decrease in predicted survival.


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