Impact of KRAS mutations in clinical features and survival in pancreatic cancer patients: a single institution experience

Abstract

chemotherapy was 3 months. Chemotherapy regimens were FOLFOX in 45 patients (83%), Capecitabin in 6 patients (11%) and FLEX in 3 patients (6%). Only 34 patients had received all the planned adjuvant courses (63%). Thirteen patients (23%) relapsed with a mean time to relapse of 11 months. mean disease-free survival was 23 months and mean overall survival was 29.5 months All the analysed factors (histopathological type, differentiation degree, vascular embolisms, perineural neoplastic invasion, resection margins, lymph nodes number, chemotherapy delay, chemotherapy regimens, number of chemotherapy courses) had no impact on overall survival and relapse-free survival. In the metastatic subgroup, patients had liver metastasis in 29 cases (66%), lung metastasis in 11 cases (25%), and 4 patients had metastasis in other sites (9%). RAS testing was performed in only 19 cases and was wild in 12 cases (63%). Liver metastasis were resectable in 3%, potentially resectable in 37.5%, and non-resectable in 59.5%. First line chemotherapy was FOLFOX in most of cases (53%), FOLFOX or FOLFIRI in the second line and capecitabine in the third line. Response rates were 14% after the first and the second line. Only 4 patients had targeted therapy in the second line with a mean number of courses of 7. Overall survival was 16.3 months and progression-free survival was 11.9 months in this study. All the analysed factors (tumor location, RAS mutation status, metastasis location, liver metastasis resection status, treatment with targeted therapy ) had no impact on overall survival and progressionfree survival. Conclusion: Colon cancer management is still a challenge in Tunisia. Access to targeted therapy in metastatic colon cancer is still difficult for our patients.

Diagnostic, Predictive and Prognostic Molecular Biomarkers in Pancreatic Cancer: An Overview for Clinicians

“…Patients with the KRAS mutation in cfDNA were found to have a significantly shorter survival compared to patients without KRAS mutations [ 53 ]. KRAS mutations detected in PDAC tissue samples have been associated with the poorer survival of patients across all stages [ 54 ]. Specific KRAS mutations (Kras G12D and Kras G12V ) have been identified as independent survival prognostic markers, and the Kras G12V mutation has been associated with increased levels of regulatory T cells and worse prognosis [ 55 ].…”