KRAS mutation in cell-free DNA (cfDNA) may be associated with treatment response to gemcitabine plus cisplatin chemotherapy in patients with pancreatic cancer, a study presented at American Association for Cancer Research (AACR) Annual Meeting 2016 has shown.1

Although cfDNA of patients with cancer has been a useful biomarker for minimal residual disease detection and treatment monitoring, its role in pancreatic cancer is less clear. Therefore, researchers sought to investigate the applicability of cfDNA as a biomarker for response and prognosis by comparing changes of the KRAS mutation in patients with pancreatic cancer before and after treatment.

For the study, researchers analyzed serum samples from 44 patients with pancreatic cancer who were treated with gemcitabine plus cisplatin. Of the 44 patients, 61% had a positive KRAS mutation before treatment and 47% had a positive mutation after treatment.

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Results showed that among patients with a positive presence of KRAS mutation, 50% of KRAS mutations were observed in patients who achieved a partial response after chemotherapy and 61% were seen in those who had stable disease after treatment.

In contrast, 100% of the 5 patients with progressive disease had a KRAS mutation, suggesting an association with treatment response (P = .046).

Researchers also found that the fraction change of the KRAS mutation was reduced in 58.1% of patients and increased in 41.9% following treatment with chemotherapy; however, there was no significant association between the direction in fraction change and survival.

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Prospective studies in patients with pancreatic cancer are warranted to confirm the association between KRAS mutation in cfDNA and response to gemcitabine/cisplatin chemotherapy.


  1. Kim MK, Kyong-Ah Y, Myung WS, et al. KRAS mutation in cell-free DNA was correlated with treatment response to gemcitabine/cisplatin chemotherapy in patients with pancreatic cancer. Poster presentation at: AACR Annual Meeting 2016; April 16-20, 2016; New Orleans, LA.