Pancreatic Cancer Clinical Trial
Official title:
KRAS (Kirsten Rat Sarcoma) Mutant CIrculating Tumor DNA for Monitoring Response to First Line Chemotherapy in Locally Advanced and Metastatic PANcreatic Cancer
With an incidence of more than 11,600 new cases per year in France and an annual number of
deaths close to the incidence rate, adenocarcinoma of the pancreas is a public health
problem.
The aim of this study is to assess the predictive value of response to the 1st line of
chemotherapy of mutated KRAS ctDNA (circulating tumor DNA) in unresectable metastatic or
locally advanced pancreatic adenocarcinomas.
With an incidence of more than 11,600 new cases per year in France and an annual number of
deaths close to the incidence rate, adenocarcinoma of the pancreas is a public health problem
especially since there is a significant increase in its incidence. incidence (+ 417% between
1980 and 2012).
Most often diagnosed late, pancreatic adenocarcinoma is managed at a metastatic stage in 60
to 70% of cases with a very poor prognosis (8.7 to 11.1 months median survival with current
chemotherapies). The first line of chemotherapy therefore represents a major issue in the
management of these unresectable patients. There are few predictive markers of response to
chemotherapy in pancreatic adenocarcinoma. It is conventionally evaluated by scanner every 2
to 3 months. The response to chemotherapy is associated with a good prognosis while
non-response has a poor prognosis and requires a 2nd line of treatment if the patient is able
to receive it.
A KRAS mutation is present in approximately 70-90% of pancreatic adenocarcinomas. Its
research on tissue sampling (fine needle aspiration or anatomo-pathological specimen) is not
carried out routinely because no prognostic or predictive value of KRAS mutations has been
demonstrated. New high-throughput DNA sequencing techniques have been developed and now allow
a blood sample to detect and quantify circulating tumor DNA (ctDNA), including KRAS
mutations.
Very few studies have investigated the change in cDNA levels during 1st line chemotherapy in
unresectable pancreatic adenocarcinoma.
The aim of this study is to assess the predictive value of response to the 1st line of
chemotherapy of mutated KRAS cDNA in unresectable metastatic or locally advanced pancreatic
adenocarcinomas.
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