Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest types of cancer. The 5-year overall survival rate is 2% in patients with metastatic pancreatic cancer. Different treatments have been shown to benefit patients with this tumor. Therefore, disease monitoring is important for selecting effective treatments. Biomarkers such as CA19-9, and carcinoembryonic antigen (CEA) are used for disease monitoring. However, those biomarkers do not always reflect disease course and activity. For example, CA19-9 cannot be detected in 5-10% of patients, and patients with obstructive jaundice could cause CA19-9 elevation. Circulating tumor DNA (ctDNA) is a good material for cancer genetic information detection. ctDNA has been used in prognosis, disease monitoring or resistance mutation detection in multiple cancer types. In this study, the authors used next generation sequencing to detect the KRAS mutation in patient’s ctDNA. The data showed that ctDNA correlated with CA19-9, imaging, and clinical outcome. The survival analysis revealed that patients with KRAS ctDNA had shorter survival than those without (8 vs. 37.5 months). This study indicated that circulating tumor DNA is an effective tool for disease monitoring in patients with pancreatic cancer.
Perets R, et al, Oncologist. 23(5):566-572, 2018