{"entity":{"id":"paper-groot-kras-ctdna-clinical-test-resected-pancreatic-ccr-2019","kind":"paper","name":"Circulating tumor DNA as a clinical test in resected pancreatic cancer","aka":[],"tldr":"A clinically accredited blood test for the four common KRAS mutations found tumour DNA in half of 59 patients before surgery and predicted recurrence afterwards with 90% sensitivity, about three months before the scan.","summary":"Digital droplet PCR was used in a CLIA and CAP-certified laboratory to detect the major pancreatic KRAS mutations (G12D, G12V, G12R, Q61H) in liquid biopsies, with 290 preoperative and longitudinal postoperative plasma samples from 59 patients. ctDNA was detected preoperatively in 29 (49%) and independently predicted decreased recurrence-free and overall survival. Patients who had neoadjuvant chemotherapy were less likely to have preoperative ctDNA (21% versus 69%). Levels dropped after resection; persistence immediately afterwards went with a high recurrence rate and median recurrence-free survival of 5 months. ctDNA during follow-up predicted recurrence with 90% sensitivity and 88% specificity at a median lead time of 84 days; detection during follow-up gave median overall survival 17 months against not reached at 30 months.","asOf":"2026-09-24","links":[{"label":"Groot et al., Clin Cancer Res 2019: KRAS ctDNA as a clinical laboratory test in 59 resected patients","url":"https://doi.org/10.1158/1078-0432.CCR-19-0197"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/31142500/"}],"tags":[],"related":["ctdna-mrd-positive"],"cancers":["pancreatic","resectable-pdac"],"sections":[],"technologies":["liquid-biopsy","mrd-testing"],"targets":["kras"],"drugs":[],"companies":[],"institutions":["johns-hopkins"],"pathways":[],"terms":["ctdna","mrd"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["clinical-cancer-research"],"dependsOn":[],"notes":[],"journal":"Clinical Cancer Research","year":2019,"doi":"10.1158/1078-0432.CCR-19-0197","pmid":"31142500","authors":"Groot VP, Mosier S, Javed AA, et al.","paperType":"observational","findings":["Preoperative ctDNA in 49%; neoadjuvant chemotherapy lowers it to 21% from 69%.","Follow-up ctDNA predicted recurrence with 90% sensitivity and 88% specificity, lead time 84 days.","Detection during follow-up: overall survival 17 months versus not reached."],"whatItMeans":"It shows a KRAS ctDNA test can be run to clinical laboratory standards in this disease, and it quantifies the lead time a surveillance programme would gain.","caveats":["Four KRAS mutations only; 59 patients.","No trial has shown that earlier detection of recurrence changes outcome."],"changedPractice":false,"participants":59},"route":"/key-papers/paper-groot-kras-ctdna-clinical-test-resected-pancreatic-ccr-2019/","neighbours":{"biomarker":[{"id":"ctdna-mrd-positive","kind":"biomarker","name":"ctDNA MRD positivity (molecular residual disease after curative treatment)","route":"/biomarkers/ctdna-mrd-positive/"}],"cancer":[{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"},{"id":"resectable-pdac","kind":"cancer","name":"Resectable pancreatic ductal adenocarcinoma","route":"/cancers/resectable-pdac/"}],"technology":[{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"},{"id":"mrd-testing","kind":"technology","name":"MRD / molecular residual disease testing","route":"/technologies/mrd-testing/"}],"target":[{"id":"kras","kind":"target","name":"KRAS","route":"/targets/kras/"}],"institution":[{"id":"johns-hopkins","kind":"institution","name":"Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center","route":"/institutions/johns-hopkins/"}],"term":[{"id":"ctdna","kind":"term","name":"Circulating tumour DNA (ctDNA)","route":"/terms/ctdna/"},{"id":"mrd","kind":"term","name":"Minimal / molecular residual disease (MRD)","route":"/terms/mrd/"}],"journal":[{"id":"clinical-cancer-research","kind":"journal","name":"Clinical Cancer Research","route":"/journals/clinical-cancer-research/"}],"drug":[{"id":"signatera","kind":"drug","name":"Signatera","route":"/drugs/signatera/"}]}}