# KRAS G12D mutation subtype is a prognostic factor for advanced pancreatic adenocarcinoma

Source: https://onco.cc/key-papers/paper-bournet-kras-g12d-prognosis-pancreatic-ctg-2016/  
OnCo record `paper-bournet-kras-g12d-prognosis-pancreatic-ctg-2016` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Genotyping needle biopsies from 219 patients with advanced pancreatic cancer showed the KRAS G12D allele carried the shortest survival, six months against nine for other alleles and fourteen for G12R.

## Summary

Multicentre prospective study: exon-2 KRAS status on EUS-guided fine-needle aspiration of the primary in locally advanced or metastatic pancreatic ductal carcinoma, with survival adjusted for age, stage, performance status, CA 19-9 and treatment. Of 219 patients, 147 had a codon-12 mutation (G12D 73, G12V 53, G12R 21) and 72 were wild-type. Survival did not differ between mutant and wild-type (8 versus 9 months), but G12D carried 6 months against 9 for the rest (hazard ratio 1.47), with G12V 9 and G12R 14 months; results held among 162 chemotherapy-treated patients (hazard ratio 1.66) and in multivariate analysis (1.44).

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Journal: Clinical and Translational Gastroenterology
- Year: 2016
- DOI: 10.1038/ctg.2016.18
- Authors: Bournet B, Muscari F, Buscail C, et al.
- Findings: G12D 73, G12V 53, G12R 21 of 147 codon-12 mutations.; G12D overall survival 6 months versus 9 (hazard ratio 1.47); G12R 14 months.
- What it means: It is the allele-level prognosis behind reading the KRAS variant rather than 'KRAS mutant', and it shows the older EUS assay over-called wild-type (33%).
- Caveats: Single-gene exon-2 assay on cytology; the 33% wild-type rate reflects low cellularity.; Treatment was heterogeneous.

## Sources

- Bournet et al., Clin Transl Gastroenterol 2016: KRAS G12D and prognosis in 219 advanced patients: https://doi.org/10.1038/ctg.2016.18
- PubMed: https://pubmed.ncbi.nlm.nih.gov/27010960/

## Connected records

- biomarkers: [KRAS G12D (and other non-G12C KRAS mutations)](https://onco.cc/biomarkers/kras-g12d/)
- cancers: [Locally advanced unresectable pancreatic ductal adenocarcinoma](https://onco.cc/cancers/locally-advanced-pdac/), [Metastatic pancreatic ductal adenocarcinoma](https://onco.cc/cancers/metastatic-pdac/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- targets: [KRAS](https://onco.cc/targets/kras/)
- terms: [KRAS mutation subtypes (G12C, G12D, G12V)](https://onco.cc/terms/kras-mutation-subtypes/)
- trials: [RASolute 302](https://onco.cc/trials/rasolute-302/)
- technologies: [KRAS & RAS inhibitors](https://onco.cc/technologies/kras-inhibitors/)

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