Kras Gene Analysis Using Liquid-Based Cytology Specimens Predicts Therapeutic Responses and Prognosis in Patients with Pancreatic Cancer

Cancers

Ke Wan¹  Toshio Shimokawa¹  Hirokazu Nagai²  Ibu Matsuzaki²  Yuichi Kinoshita²  Reiko Ashida³  Masahiro Itonaga³  Yasunobu Yamashita³  Tomoya Emori³  Keiichi Hatamaru³  Takashi Tamura³  Yuudai Kayama³  Masayuki Kitano³  Yuki Kawaji³  Hiroki Yamaue⁴  Manabu Kawai⁴  Shin-Ichi Murata⁴ 

[1] Clinical Study Support Center, Wakayama Medical University, Wakayama 641-0012, Japan;Department of Human Pathology, Wakayama Medical University, Wakayama 641-0012, Japan;Second Department of Internal Medicine, Wakayama Medical University, Wakayama 641-0012, Japan;Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama 641-0012, Japan;

关键词: Kras;    pancreatic ductal adenocarcinoma;    pancreatic cancer;    gemcitabine and nab-paclitaxel;    EUS-FNA;    liquid-based cytology;   

DOI  :  10.3390/cancers14030551

来源: DOAJ

【 摘 要 】

Background: Although several molecular analyses have shown that the Kras gene status is related to long-term survival of patients with pancreatic ductal adenocarcinoma (PDAC), the results remain controversial. Here, we examined the Kras gene status in a cohort of unresectable PDAC patients who underwent first-line therapy with gemcitabine and nab-paclitaxel (GA) and assessed differences in chemotherapy responses and survival. Methods: Patients with a histological diagnosis of PDAC (based on EUS-guided fine-needle aspiration) from 2017 to 2019 were enrolled. Tumor genomic DNA was extracted from residual liquid-based cytology specimens and Kras mutations were assessed using the quenching probe method. The relationships between the Kras status and progression-free survival (PFS) and overall survival (OS) were assessed. Results: Of the 110 patients analyzed, 15 had wild-type Kras. Those with the wild-type gene showed significantly longer PFS and OS than those with mutant Kras (6.9/5.3 months (p = 0.044) vs. 19.9/11.8 months (p = 0.037), respectively). Multivariate analyses identified wild-type Kras as a significant independent factor associated with longer PFS and OS (HR = 0.53 (p = 0.045) and HR = 0.35 (p = 0.007), respectively). Conclusions: The analysis of the Kras gene status could be used to predict therapeutic responses to GA and prognosis in unresectable PDAC patients.

【 授权许可】

Unknown