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@ARTICLE{Reissig:275929,
author = {T. M. Reissig$^*$ and I. Tzianopoulos$^*$ and S.-T.
Liffers$^*$ and V. K. Rosery$^*$ and M. Guyot and S. Ting
and M. Wiesweg$^*$ and S. Kasper$^*$ and P. Meister and T.
Herold and H. H. Schmidt and B. Schumacher and D. Albers and
P. Markus and J. Treckmann and M. Schuler$^*$ and H.-U.
Schildhaus$^*$ and J. T. Siveke$^*$},
title = {{S}maller panel, similar results: genomic profiling and
molecularly informed therapy in pancreatic cancer.},
journal = {ESMO open},
volume = {8},
number = {3},
issn = {2059-7029},
address = {London},
publisher = {BMJ},
reportid = {DKFZ-2023-00917},
pages = {101539},
year = {2023},
abstract = {Pancreatic cancer has a dismal prognosis. One reason is
resistance to cytotoxic drugs. Molecularly matched therapies
might overcome this resistance but the best approach to
identify those patients who may benefit is unknown.
Therefore, we sought to evaluate a molecularly guided
treatment approach.We retrospectively analyzed the clinical
outcome and mutational status of patients with pancreatic
cancer who received molecular profiling at the West German
Cancer Center Essen from 2016 to 2021. We carried out a
47-gene DNA next-generation sequencing (NGS) panel.
Furthermore, we assessed microsatellite
instability-high/deficient mismatch repair (MSI-H/dMMR)
status and, sequentially and only in case of KRAS wild-type,
gene fusions via RNA-based NGS. Patient data and treatment
were retrieved from the electronic medical records.Of 190
included patients, 171 had pancreatic ductal adenocarcinoma
$(90\%).$ One hundred and three patients had stage IV
pancreatic cancer at diagnosis $(54\%).$ MMR analysis in 94
patients (94/190, $49.5\%)$ identified 3 patients with dMMR
(3/94, $3.2\%).$ Notably, we identified 32 patients with
KRAS wild-type status $(16.8\%).$ To identify driver
alterations in these patients, we conducted an RNA-based
fusion assay on 13 assessable samples and identified 5
potentially actionable fusions (5/13, $38.5\%).$ Overall, we
identified 34 patients with potentially actionable
alterations (34/190, $17.9\%).$ Of these 34 patients, 10
patients (10/34, $29.4\%)$ finally received at least one
molecularly targeted treatment and 4 patients had an
exceptional response (>9 months on treatment).Here, we show
that a small-sized gene panel can suffice to identify
relevant therapeutic options for pancreatic cancer patients.
Informally comparing with previous large-scale studies, this
approach yields a similar detection rate of actionable
targets. We propose molecular sequencing of pancreatic
cancer as standard of care to identify KRAS wild-type and
rare molecular subsets for targeted treatment strategies.},
keywords = {Archer (Other) / KRAS wild-type (Other) / NGS (Other) /
targeted sequencing (Other) / targeted therapy (Other)},
cin = {ED01},
ddc = {610},
cid = {I:(DE-He78)ED01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:37148593},
doi = {10.1016/j.esmoop.2023.101539},
url = {https://inrepo02.dkfz.de/record/275929},
}