ArticleESMO open2025
Precision medicine strategy in pancreatic ductal adenocarcinoma.
Article in ESMO open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Comment on 'Evaluation of HER2/neu status in metastatic lymph nodes synchronous with the primary tumor in periampullary region malignancies'.Irish journal of medical science · 2026Article
- Pancreatic ductal adenocarcinoma and pancreatic surgery in the 21st century: triumphs, turning points, and unresolved challenges.Updates in surgery · 2026Review
- Targeted Therapy in Pancreatic Ductal Adenocarcinoma: Current Advances and Challenges.Current oncology (Toronto, Ont.) · 2026Review
- The Progress of Pancreatectomy for Pancreatic Cancer Treatment-Lessons Learned and Future Challenges.Cancers · 2026Review
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPancreatic ductal adenocarcinoma (PDAC) is a highly lethal cancer with limited therapeutic options. Integration of molecular profiling may enable personalized treatment approaches. We evaluated the clinical utility of molecularly matched treatment (MMT) in a real-life cohort of PDAC patients. PATIENTS AND
methodsA retrospective chart review of clinical/molecular data was carried out, including all PDAC patients with a contributive molecular profile. Survival outcomes were compared across three groups: patients with actionable molecular alterations (MAs) who received MMT (MA/MMT), patients with actionable alterations without MMT (MA/No MMT), and patients without actionable alterations (No MA/No MMT).
resultsAmong 342 patients (median age 61 years; 48% female; 95% Eastern Cooperative Oncology Group 0-1), molecular profiling was carried out using tissue (50%), liquid biopsy (45%), or both (5%). The most common gene alterations were KRAS (84%), TP53 (72%), and CDKN2A (26%). Actionable alterations were found in 69 patients (20%), with 31 (45%) receiving MMT. Targeted therapies included notably olaparib (BRCA2), trastuzumab (HER2), and KRAS G12C inhibitors. Median overall survival (OS) from metastatic diagnosis was significantly longer in the MA/MMT group (32.9 months) compared with MA/No MMT (12.9 months) and No MA/No MMT groups (17.6 months) (P = 0.0008). From initial diagnosis, OS was 34.9, 27.1, and 21.5 months, respectively (P = 0.005). Median progression-free survival from MMT initiation was 5.5 months. The mean growth modulation index was 1.7 in the MA/MMT group versus 0.8 in the MA/No MMT group (P < 0.05). In variate analysis, MMT was correlated with improved OS [hazard ratio (HR) 0.51, P < 0.001 from metastasis; HR 0.59, P < 0.01 from diagnosis].
conclusionTo conclude, molecular profiling identified actionable alterations in 20% of PDAC patients. MMT was associated with a significant survival benefit, supporting molecular profiling into routine management, especially with the perspective of KRAS inhibitors.
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