Pancreatic Cancer Research Uncovers Optimal KRAS Mutant Concentration for Prognosis and Monitoring

Strategic Insights -

Investigators at the National Cancer Center in South Korea have published a new study on the clinical significance of circulating tumor DNA (ctDNA) KRAS mutations in patients with pancreatic adenocarcinoma (PAC). The research aimed to propose a cut-off value of mutant KRAS (mKRAS) concentration in ctDNA and validate its clinical utility. A prospective, multicenter cohort study enrolled 419 patients with PAC, and mKRAS was determined using multiplex droplet digital polymerase chain reaction at baseline and longitudinal follow-up time points. The optimal cut-off value of mKRAS concentration for progression-free survival (PFS) established in the development cohort was validated for PFS and overall survival (OS) in the validation cohort. The research concluded that a high mKRAS concentration was associated with shorter PFS and OS in patients with PAC.

Key Takeaways:

  • The study proposed a cut-off value of 160 copies/mL of mutant KRAS (mKRAS) concentration in ctDNA for predicting prognosis and monitoring in patients with pancreatic adenocarcinoma (PAC).
  • The study enrolled 419 patients with PAC and used multiplex droplet digital polymerase chain reaction to determine mKRAS concentration at baseline and follow-up time points.
  • The optimal cut-off value of mKRAS concentration for progression-free survival (PFS) was established in the development cohort and validated for PFS and overall survival (OS) in the validation cohort.
  • A high mKRAS concentration was associated with shorter PFS (13.6 vs 6.4 months) and OS in patients with PAC.
  • The clinical significance of mKRAS detection in plasma was also observed in patients with normal CA19-9.
  • The study was funded by the National Cancer Center, Korea, and the NCC Bio Bank of National Cancer Center, Korea.
  • Additional authors on the research include Jung Won Chun, Sung-Sik Han, Sang-Jae Park, Woo Jin Lee, Yun-Hee Kim, Sun-Young Kong, Dong-Eun Lee, Min Kyeong Kim, Jin-Hyeok Hwang, Sang Hyub Lee, Min Kyu Jung, Eui Joo Kim, and Dong-Won Ahn.

Statistics:

  • 419 patients were enrolled in the study with pancreatic adenocarcinoma (PAC).
  • mKRAS concentration was determined using multiplex droplet digital polymerase chain reaction in 419 patients.
  • The optimal cut-off value of mKRAS concentration for PFS was established in 200 patients (development cohort).
  • The validation cohort included 219 patients who were used to validate the cut-off value for PFS and OS.
  • A high mKRAS concentration was associated with shorter PFS (13.6 vs 6.4 months) and OS in patients with PAC.

Sources:

  • Optimal Value of Mutant Kras Circulating Tumor Dna for Predicting Prognosis and Monitoring In Patients With Pancreatic Adenocarcinoma: a Prospective Multicenter Cohort Study. Clinical Chemistry, 2025.
  • Health & Medicine Week. July 25, 2025; p 4775.
  • National Cancer Center, Korea.
  • NCC Bio Bank of National Cancer Center, Korea.