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Bringing Hope to Improve Treatment in Pancreatic Ductal Adenocarcinoma

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Resumo:Background/Objectives: Pancreatic ductal adenocarcinoma (PDAC) incidence is rising, and prognosis remains poor due to late diagnosis and limited effective therapies. Currently, patients are treated based on TNM staging, without molecular tumor characterization. This study aimed to validate a technique that combines the amplification refractory mutation system (ARMS) with high-resolution melting analysis (HRMA) for detecting mutations in codon 12 of KRAS in tumor and plasma, and to assess its prognostic value. Methods: Prospective study including patients with newly diagnosed PDAC with tumor and plasma samples collected before treatment. Mutations in codon 12 of KRAS (G12D, G12V, G12C, and G12R) were detected using ARMS–HRMA and compared to Sanger sequencing (SS). Univariate and multivariate analyses were used to evaluate the prognostic significance of these mutations. Results: A total of 88 patients, 93% with ECOG-PS 0–1, 57% with resectable disease. ARMS–HRMA technique showed a higher sensitivity than SS, both in tumor and plasma (77% vs. 51%; 25 vs. 0%, respectively). The most frequent mutation was G12D (n = 32, 36%), followed by G12V (n = 22, 25%). On multivariate analysis, patients with G12D and/or G12C mutations, either in tumor or plasma, had lower PFS (HR 1.792, 95% CI 1.061–3.028, p = 0.029; HR 2.081, 95% CI 1.014–4.272, p = 0.046, respectively) and lower OS (HR 1.757, 95% CI 1.013–3.049, p = 0.045; HR 2.229, 95% CI 1.082–4.594, p = 0.030, respectively). Conclusions: ARMS–HRMA is a rapid and cost-effective method for detecting KRAS mutations in PDAC patients, offering the potential for stratifying prognosis and guiding treatment decisions. The presence of G12D and G12C mutations in both tumor and plasma is associated with a poorer prognosis.
Autores principais:Bravo, Ana Catarina
Outros Autores:Morão, Bárbara; Luz, André; Dourado, Rúben; Oliveira, Beatriz; Guedes, Ana; Moreira-Barbosa, Catarina; Fidalgo, Catarina; Mascarenhas-Lemos, Luís; Costa-Santos, Maria Pia; Maio, Rui; Paulino, Jorge; Viana Baptista, Pedro; Fernandes, Alexandra R.; Cravo, Marília
Assunto:amplification refractory mutation system ARMS–HRMA ctDNA KRAS mutations liquid biopsy pancreatic cancer prognosis Oncology Cancer Research SDG 3 - Good Health and Well-being
Ano:2024
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Universidade Nova de Lisboa
Idioma:inglês
Origem:Repositório Institucional da UNL
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author Bravo, Ana Catarina
author2 Morão, Bárbara
Luz, André
Dourado, Rúben
Oliveira, Beatriz
Guedes, Ana
Moreira-Barbosa, Catarina
Fidalgo, Catarina
Mascarenhas-Lemos, Luís
Costa-Santos, Maria Pia
Maio, Rui
Paulino, Jorge
Viana Baptista, Pedro
Fernandes, Alexandra R.
Cravo, Marília
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author_facet Bravo, Ana Catarina
Morão, Bárbara
Luz, André
Dourado, Rúben
Oliveira, Beatriz
Guedes, Ana
Moreira-Barbosa, Catarina
Fidalgo, Catarina
Mascarenhas-Lemos, Luís
Costa-Santos, Maria Pia
Maio, Rui
Paulino, Jorge
Viana Baptista, Pedro
Fernandes, Alexandra R.
Cravo, Marília
author_role author
contributor_name_str_mv DCV - Departamento de Ciências da Vida
UCIBIO - Applied Molecular Biosciences Unit
Faculdade de Ciências e Tecnologia (FCT)
MDPI - Multidisciplinary Digital Publishing Institute
RUN
country_str PT
creators_json_txt [{\"Person.name\":\"Bravo, Ana Catarina\"},{\"Person.name\":\"Morão, Bárbara\"},{\"Person.name\":\"Luz, André\"},{\"Person.name\":\"Dourado, Rúben\"},{\"Person.name\":\"Oliveira, Beatriz\"},{\"Person.name\":\"Guedes, Ana\"},{\"Person.name\":\"Moreira-Barbosa, Catarina\"},{\"Person.name\":\"Fidalgo, Catarina\"},{\"Person.name\":\"Mascarenhas-Lemos, Luís\"},{\"Person.name\":\"Costa-Santos, Maria Pia\"},{\"Person.name\":\"Maio, Rui\"},{\"Person.name\":\"Paulino, Jorge\"},{\"Person.name\":\"Viana Baptista, Pedro\"},{\"Person.name\":\"Fernandes, Alexandra R.\"},{\"Person.name\":\"Cravo, Marília\"}]
datacite.contributors.contributor.contributorName.fl_str_mv DCV - Departamento de Ciências da Vida
UCIBIO - Applied Molecular Biosciences Unit
Faculdade de Ciências e Tecnologia (FCT)
MDPI - Multidisciplinary Digital Publishing Institute
RUN
datacite.creators.creator.creatorName.fl_str_mv Bravo, Ana Catarina
Morão, Bárbara
Luz, André
Dourado, Rúben
Oliveira, Beatriz
Guedes, Ana
Moreira-Barbosa, Catarina
Fidalgo, Catarina
Mascarenhas-Lemos, Luís
Costa-Santos, Maria Pia
Maio, Rui
Paulino, Jorge
Viana Baptista, Pedro
Fernandes, Alexandra R.
Cravo, Marília
datacite.date.Accepted.fl_str_mv 2024-10-01T00:00:00Z
datacite.date.available.fl_str_mv 2025-02-24T21:50:54Z
datacite.date.embargoed.fl_str_mv 2025-02-24T21:50:54Z
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv amplification refractory mutation system
ARMS–HRMA
ctDNA
KRAS mutations
liquid biopsy
pancreatic cancer
prognosis
Oncology
Cancer Research
SDG 3 - Good Health and Well-being
datacite.titles.title.fl_str_mv Bringing Hope to Improve Treatment in Pancreatic Ductal Adenocarcinoma
A New Tool for Molecular Profiling of KRAS Mutations in Tumor and Plasma Samples
dc.contributor.none.fl_str_mv DCV - Departamento de Ciências da Vida
UCIBIO - Applied Molecular Biosciences Unit
Faculdade de Ciências e Tecnologia (FCT)
MDPI - Multidisciplinary Digital Publishing Institute
RUN
dc.creator.none.fl_str_mv Bravo, Ana Catarina
Morão, Bárbara
Luz, André
Dourado, Rúben
Oliveira, Beatriz
Guedes, Ana
Moreira-Barbosa, Catarina
Fidalgo, Catarina
Mascarenhas-Lemos, Luís
Costa-Santos, Maria Pia
Maio, Rui
Paulino, Jorge
Viana Baptista, Pedro
Fernandes, Alexandra R.
Cravo, Marília
dc.date.Accepted.fl_str_mv 2024-10-01T00:00:00Z
dc.date.available.fl_str_mv 2025-02-24T21:50:54Z
dc.date.embargoed.fl_str_mv 2025-02-24T21:50:54Z
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv http://hdl.handle.net/10362/179688
dc.language.none.fl_str_mv eng
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.subject.none.fl_str_mv amplification refractory mutation system
ARMS–HRMA
ctDNA
KRAS mutations
liquid biopsy
pancreatic cancer
prognosis
Oncology
Cancer Research
SDG 3 - Good Health and Well-being
dc.title.fl_str_mv Bringing Hope to Improve Treatment in Pancreatic Ductal Adenocarcinoma
A New Tool for Molecular Profiling of KRAS Mutations in Tumor and Plasma Samples
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description Background/Objectives: Pancreatic ductal adenocarcinoma (PDAC) incidence is rising, and prognosis remains poor due to late diagnosis and limited effective therapies. Currently, patients are treated based on TNM staging, without molecular tumor characterization. This study aimed to validate a technique that combines the amplification refractory mutation system (ARMS) with high-resolution melting analysis (HRMA) for detecting mutations in codon 12 of KRAS in tumor and plasma, and to assess its prognostic value. Methods: Prospective study including patients with newly diagnosed PDAC with tumor and plasma samples collected before treatment. Mutations in codon 12 of KRAS (G12D, G12V, G12C, and G12R) were detected using ARMS–HRMA and compared to Sanger sequencing (SS). Univariate and multivariate analyses were used to evaluate the prognostic significance of these mutations. Results: A total of 88 patients, 93% with ECOG-PS 0–1, 57% with resectable disease. ARMS–HRMA technique showed a higher sensitivity than SS, both in tumor and plasma (77% vs. 51%; 25 vs. 0%, respectively). The most frequent mutation was G12D (n = 32, 36%), followed by G12V (n = 22, 25%). On multivariate analysis, patients with G12D and/or G12C mutations, either in tumor or plasma, had lower PFS (HR 1.792, 95% CI 1.061–3.028, p = 0.029; HR 2.081, 95% CI 1.014–4.272, p = 0.046, respectively) and lower OS (HR 1.757, 95% CI 1.013–3.049, p = 0.045; HR 2.229, 95% CI 1.082–4.594, p = 0.030, respectively). Conclusions: ARMS–HRMA is a rapid and cost-effective method for detecting KRAS mutations in PDAC patients, offering the potential for stratifying prognosis and guiding treatment decisions. The presence of G12D and G12C mutations in both tumor and plasma is associated with a poorer prognosis.
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eu_rights_str_mv openAccess
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fulltext.url.fl_str_mv https://run.unl.pt/bitstreams/bebf41a5-fe31-4b06-ae15-7fdf07b54b26/download
funder_facet_str_mv FCT{{{_:::_}}}Fundação para a Ciência e a Tecnologia
FCT{{{_:::_}}}Fundação para a Ciência e a Tecnologia
funding.funder.alternateName_str_mv FCT
FCT
funding.funder.identifier_str_mv http://doi.org/10.13039/501100001871
http://doi.org/10.13039/501100001871
funding.funder.name_str_mv Fundação para a Ciência e a Tecnologia
Fundação para a Ciência e a Tecnologia
funding.name_str_mv 6817 - DCRRNI ID
OE
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identifier.url.fl_str_mv http://hdl.handle.net/10362/179688
inst_facet_str urn:organizationAcronym:unl{{{_:::_}}}Universidade Nova de Lisboa
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institution Universidade Nova de Lisboa
instname_str Universidade Nova de Lisboa
language eng
network_acronym_str run
network_name_str Repositório Institucional da UNL
oai_identifier_str oai:run.unl.pt:10362/179688
organization_str_mv urn:organizationAcronym:unl
person_str_mv Bravo, Ana Catarina
Morão, Bárbara
Luz, André
Dourado, Rúben
Oliveira, Beatriz
Guedes, Ana
Moreira-Barbosa, Catarina
Fidalgo, Catarina
Mascarenhas-Lemos, Luís
Costa-Santos, Maria Pia
Maio, Rui
Paulino, Jorge
Viana Baptista, Pedro
Fernandes, Alexandra R.
Cravo, Marília
publishDate 2024
repo_facet_str urn:repositoryAcronym:run{{{_:::_}}}Repositório Institucional da UNL
reponame_str Repositório Institucional da UNL
repository_id_str urn:repositoryAcronym:run
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spelling engenBackground/Objectives: Pancreatic ductal adenocarcinoma (PDAC) incidence is rising, and prognosis remains poor due to late diagnosis and limited effective therapies. Currently, patients are treated based on TNM staging, without molecular tumor characterization. This study aimed to validate a technique that combines the amplification refractory mutation system (ARMS) with high-resolution melting analysis (HRMA) for detecting mutations in codon 12 of KRAS in tumor and plasma, and to assess its prognostic value. Methods: Prospective study including patients with newly diagnosed PDAC with tumor and plasma samples collected before treatment. Mutations in codon 12 of KRAS (G12D, G12V, G12C, and G12R) were detected using ARMS–HRMA and compared to Sanger sequencing (SS). Univariate and multivariate analyses were used to evaluate the prognostic significance of these mutations. Results: A total of 88 patients, 93% with ECOG-PS 0–1, 57% with resectable disease. ARMS–HRMA technique showed a higher sensitivity than SS, both in tumor and plasma (77% vs. 51%; 25 vs. 0%, respectively). The most frequent mutation was G12D (n = 32, 36%), followed by G12V (n = 22, 25%). On multivariate analysis, patients with G12D and/or G12C mutations, either in tumor or plasma, had lower PFS (HR 1.792, 95% CI 1.061–3.028, p = 0.029; HR 2.081, 95% CI 1.014–4.272, p = 0.046, respectively) and lower OS (HR 1.757, 95% CI 1.013–3.049, p = 0.045; HR 2.229, 95% CI 1.082–4.594, p = 0.030, respectively). Conclusions: ARMS–HRMA is a rapid and cost-effective method for detecting KRAS mutations in PDAC patients, offering the potential for stratifying prognosis and guiding treatment decisions. The presence of G12D and G12C mutations in both tumor and plasma is associated with a poorer prognosis.application/pdfenBringing Hope to Improve Treatment in Pancreatic Ductal AdenocarcinomaSubtitleenA New Tool for Molecular Profiling of KRAS Mutations in Tumor and Plasma SamplesBravo, Ana CatarinaMorão, BárbaraLuz, AndréDourado, RúbenOliveira, BeatrizGuedes, AnaMoreira-Barbosa, CatarinaFidalgo, CatarinaMascarenhas-Lemos, LuísCosta-Santos, Maria PiaMaio, RuiPaulino, JorgeViana Baptista, PedroFernandes, Alexandra R.Cravo, MaríliaDCV - Departamento de Ciências da VidaUCIBIO - Applied Molecular Biosciences UnitFaculdade de Ciências e Tecnologia (FCT)MDPI - Multidisciplinary Digital Publishing InstituteHostingInstitutionOrganizationalRUNe-mailmailto:run@unl.ptrun@unl.ptISSNIsPartOf2072-6694URNIsPartOfPURE: 103141167URNIsPartOfPURE UUID: 6c983e7a-fadd-4cce-99a6-514ebd03cc9fURNIsPartOfWOS: 001341494800001URNIsPartOfPubMed: 39456638URNIsPartOfScopus: 85207677616URNIsPartOfORCID: /0000-0001-5255-7095/work/178851782URNIsPartOfORCID: /0000-0003-2054-4438/work/178851952DOIIsPartOf10.3390/cancers162035442025-02-24T21:50:54Z2024-102024-10-01T00:00:00ZHandlehttp://hdl.handle.net/10362/179688http://purl.org/coar/access_right/c_abf2open accessamplification refractory mutation systemARMS–HRMActDNAKRAS mutationsliquid biopsypancreatic cancerprognosisOncologyCancer ResearchSDG 3 - Good Health and Well-being2380966 bytesFundação para a Ciência e a TecnologiaApplied Molecular Biosciences Unit6817 - DCRRNI IDCrossref Funder IDhttp://doi.org/10.13039/501100001871Fundação para a Ciência e a TecnologiaGold4Exomarkers: Modulation of exosome biomarkers of drug resistance via gold nanoconjugatesOECrossref Funder IDhttp://doi.org/10.13039/501100001871literaturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://run.unl.pt/bitstreams/bebf41a5-fe31-4b06-ae15-7fdf07b54b26/download
spellingShingle Bringing Hope to Improve Treatment in Pancreatic Ductal Adenocarcinoma
Bravo, Ana Catarina
amplification refractory mutation system
ARMS–HRMA
ctDNA
KRAS mutations
liquid biopsy
pancreatic cancer
prognosis
Oncology
Cancer Research
SDG 3 - Good Health and Well-being
status SINGLETON
subject.fl_str_mv amplification refractory mutation system
ARMS–HRMA
ctDNA
KRAS mutations
liquid biopsy
pancreatic cancer
prognosis
Oncology
Cancer Research
SDG 3 - Good Health and Well-being
title Bringing Hope to Improve Treatment in Pancreatic Ductal Adenocarcinoma
title_full Bringing Hope to Improve Treatment in Pancreatic Ductal Adenocarcinoma
title_fullStr Bringing Hope to Improve Treatment in Pancreatic Ductal Adenocarcinoma
title_full_unstemmed Bringing Hope to Improve Treatment in Pancreatic Ductal Adenocarcinoma
title_short Bringing Hope to Improve Treatment in Pancreatic Ductal Adenocarcinoma
title_sort Bringing Hope to Improve Treatment in Pancreatic Ductal Adenocarcinoma
topic amplification refractory mutation system
ARMS–HRMA
ctDNA
KRAS mutations
liquid biopsy
pancreatic cancer
prognosis
Oncology
Cancer Research
SDG 3 - Good Health and Well-being
topic_facet amplification refractory mutation system
ARMS–HRMA
ctDNA
KRAS mutations
liquid biopsy
pancreatic cancer
prognosis
Oncology
Cancer Research
SDG 3 - Good Health and Well-being
url http://hdl.handle.net/10362/179688
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