KRAS ctDNA Linked to Worse Overall Survival in Localized Pancreatic Cancer

TUESDAY, July 7, 2026 (HealthDay News) — KRAS-mutant circulating tumor (ct)DNA is associated with worse overall survival (OS) in localized pancreatic ductal adenocarcinoma (PDAC), according to a study published online June 30 in Clinical Cancer Research.

Krishay Sridalla, from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues examined the prognostic significance of KRAS-mutant ctDNA detected by next-generation sequencing (NGS) and digital droplet polymerase chain reaction (ddPCR) in localized PDAC in a prospective cohort study involving 106 patients. Using tumor-agnostic NGS and ddPCR targeting KRAS G12D/V/R mutations, blood samples for ctDNA were assessed at diagnosis, post-neoadjuvant chemotherapy, and postresection.

The researchers found that KRAS ctDNA was detected in 17.2 and 64.9 percent by NGS and ddPCR, respectively, at diagnosis. There was an association seen for detection by both platforms with shorter OS, with greater prognostic discrimination provided by the higher-sensitivity ddPCR assay, which identified additional patients with poor outcomes not captured by NGS (NGS median OS, 11.2 versus 30.5 months for those with versus without ctDNA; ddPCR median OS, 24.7 versus 70.9 months). Median OS was shortest, longest, and intermediate in patients with ctDNA detected by both NGS and ddPCR, in those not detected by either platform, and in those detected only by ddPCR (10.9, 40.7, and 26.9 months, respectively).

“As we enter the era of KRAS-targeted therapies, having a screening tool that tracks the same mutation becomes increasingly important,” senior author Akhil Chawla, M.D., also from the Feinberg School of Medicine, said in a statement.

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