KRAS and TP53 ctDNA Predict Survival in Localized Pancreatic Cancer

Detecting circulating tumor DNA (ctDNA) in patients with localized pancreatic ductal adenocarcinoma (PDAC) can help predict outcomes and guide surgical decision-making.

• Mutant KRAS ctDNA was present in 19% of patients at diagnosis, with levels dropping to 4.6% after neoadjuvant chemotherapy (NAC).
• The presence of both KRAS and TP53 ctDNA at diagnosis was associated with a nearly six-fold increased risk of shorter overall survival (OS) (adjusted hazard ratio 5.66, p < 0.001).
• Higher ctDNA variant allele frequency during treatment also indicated a worse prognosis (adjusted hazard ratio 1.14, p = 0.028).

These findings suggest that ctDNA assessments can be integral in evaluating treatment response and risk stratification in localized PDAC.