Prognostic value of circulating tumour DNA in patients undergoing curative resection for pancreatic cancer.
Pancreatic ductal adenocarcinoma (PDAC) is frequently diagnosed at an advanced stage, leading to a poor prognosis. Therefore, interest in the development of non-invasive biomarkers for prognostic prediction has grown rapidly. Here, we assessed the clinical implications of v-Ki-ras2 kirsten rat sarcoma viral oncogene homolog (KRAS)-mutated circulating tumour DNA (ctDNA) as a useful surrogate biomarker in patients with resectable PDAC.



We used droplet digital polymerase chain reaction to detect rare mutant tumour-derived KRAS genes in plasma cell-free DNA (cfDNA) as ctDNA. Samples were collected from 105 patients who underwent pancreatoduodenectomy for PDAC at a single institution. Overall survival (OS) was analysed according to the presence of ctDNA.



Among the 105 cases, ctDNA was detected in 33 (31%) plasma samples. The median OS durations were 13.6 months for patients with ctDNA (ctDNA+) and 27.6 months for patients without ctDNA. Patients who were ctDNA+ had a significantly poorer prognosis with respect to OS (P<0.0001).



Our findings suggested that the presence of ctDNA in plasma samples could be an important and powerful predictor of poor survival in patients with PDAC. Accordingly, ctDNA detection might be a promising approach with respect to PDAC treatment.
Department of Surgery, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Naoto
N
Hadano
Department of Surgery, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Yoshiaki
Y
Murakami
Department of Surgery, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Kenichiro
K
Uemura
Department of Surgery, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Yasusi
Y
Hashimoto
Department of Surgery, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Naru
N
Kondo
Department of Surgery, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Naoya
N
Nakagawa
Department of Surgery, Applied Life Sciences Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Taijiro
T
Sueda
Natural Science Center for Basic Research and Development (N-BARD), Hiroshima University, Hiroshima, Japan.
Eiso
E
Hiyama
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood / Q000235:genetics / Q000473:pathology; D004273:DNA, Neoplasm / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000235:genetics / Q000473:pathology*; D011379:Prognosis; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics; D018631:ras Proteins / Q000235:genetics
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins