Evidence map›Paper›PMID 32791343›Full record

ArticleEnvironmental research2020

Influence of KRAS mutations, persistent organic pollutants, and trace elements on survival from pancreatic ductal adenocarcinoma.

Miquel Porta, José Pumarega, André F S Amaral, Jeanine M Genkinger, Judit Camargo, Lorelei Mucci, Juan Alguacil, Magda Gasull, Xuehong Zhang, Eva Morales and 4 more

Open access · greenAbstract read
In one paragraph

Article in Environmental research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
0.5field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 8 citations in OpenAlex.

  1. Trial
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  8. Disease Ionomics: Understanding the Role of Ions in Complex Disease.International journal of molecular sciences · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 7 institutions in 3 countries.

Miquel PortaSchool of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain. Electronic address: mporta@imim.es.
José PumaregaCIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain.
André F S AmaralNational Heart and Lung Institute, Imperial College London, London, United Kingdom.
Jeanine M GenkingerDepartment of Epidemiology, Columbia University, New York, USA; Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, USA.
Judit CamargoSchool of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain.
Lorelei MucciHarvard Medical School, Harvard T. H. Chan School of Public Health, Brigham and Women's Hospital, Boston, USA.
Juan AlguacilCIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Universidad de Huelva, Huelva, Spain.
Magda GasullSchool of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain.
Xuehong ZhangHarvard Medical School, Harvard T. H. Chan School of Public Health, Brigham and Women's Hospital, Boston, USA.
Eva MoralesCIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; IMIB-Arrixaca, Department of Public Health Sciences, University of Murcia.
Mar IglesiasSchool of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Hospital Del Mar Medical Research Institute (IMIM), Barcelona, Spain.
Shuji OginoHarvard Medical School, Harvard T. H. Chan School of Public Health, Brigham and Women's Hospital, Boston, USA.
Lawrence S EngelDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA.
PANKRAS II Study Group
Universitat Autònoma de Barcelona · ESBrigham and Women's Hospital · USCentro de Investigación Biomédica en Red de Epidemiología y Salud Pública · ESColumbia University Irving Medical Center · USHospital Del Mar · ESImperial College London · GBUniversity of North Carolina at Chapel Hill · US

Funding

VARIATION IN BIOACCUMULATION AND BIOMAGNIFICATION OF METALS IN NORTHERN US LAKESP42ES007373 · NIEHS · DARTMOUTH COLLEGE · PI STANTON, BRUCE A. · 1995 to 2019
$52.0M
Accelerating Transdisciplinary Epidemiology of Colorectal CancerR35CA197735 · NCI · DANA-FARBER CANCER INST · PI OGINO, SHUJI · 2015 to 2021
$6.0M
NCI NIH HHS R35 CA197735NIEHS NIH HHS P42 ES007373
6 · The paper itself

Abstract

introductionReasons why pancreatic ductal adenocarcinoma (PDAC) continues to have poor survival are only partly known. No previous studies have analyzed the combined influence of KRAS mutations, persistent organic pollutants (POPs), and trace elements upon survival in PDAC or in any other human cancer.

objectiveTo analyze the individual and combined influence of KRAS mutations, POPs, and trace elements upon survival from PDAC.

methodsIncident cases of PDAC (n = 185) were prospectively identified in five hospitals in Eastern Spain in 1992-1995 and interviewed face-to-face during hospital admission. KRAS mutational status was determined from tumour tissue through polymerase chain reaction and artificial restriction fragment length polymorphism. Blood and toenail samples were obtained before treatment. Serum concentrations of POPs were analyzed by high-resolution gas chromatography with electron-capture detection. Concentrations of 12 trace elements were determined in toenail samples by inductively coupled plasma mass spectrometry. Multivariable Cox proportional hazards regression was used to assess prognostic associations.

resultsPatients with a KRAS mutated tumor had a 70% higher risk of early death than patients with a KRAS wild-type PDAC (hazard ratio [HR] = 1.7, p = 0.026), adjusting for age, sex, and tumor stage. KRAS mutational status was only modestly and not statistically significantly associated with survival when further adjusting by treatment or by treatment intention. The beneficial effects of treatment remained unaltered when KRAS mutational status was taken into account, and treatment did not appear to be less effective in the subgroup of patients with a KRAS mutated tumor. POPs did not materially influence survival: the adjusted HR of the highest POP tertiles was near unity for all POPs. When considering the joint effect on survival of POPs and KRAS, patients with KRAS mutated tumors had modest and nonsignificant HRs (most HRs around 1.3 to 1.4). Higher concentrations of lead, cadmium, arsenic, vanadium, and aluminium were associated with better survival. When KRAS status, POPs, and trace elements were simultaneously considered along with treatment, only the latter was statistically significantly related to survival.

conclusionsIn this study based on molecular, clinical, and environmental epidemiology, KRAS mutational status, POPs, and trace elements were not adversely related to PDAC survival when treatment was simultaneously considered; only treatment was independently related to survival. The lack of adverse prognostic effects of POPs and metals measured at the time of diagnosis provide scientific and clinical reassurance on the effects of such exposures upon survival of patients with PDAC. The weak association with KRAS mutations contributes to the scant knowledge on the clinical implications of a genetic alteration highly frequent in PDAC.

Indexed as

AdenocarcinomaPancreatic NeoplasmsTrace ElementsGas Chromatography-Mass SpectrometryHumansMutationPersistent Organic PollutantsProto-Oncogene Proteins p21(ras)SpainKRAS protein, humanPersistent Organic PollutantsProto-Oncogene Proteins p21(ras)Trace ElementsKRAS oncogenemetalspancreatic cancerpancreatic ductal adenocarcinoma (PDAC)persistent organic pollutants (POPs)survivaltrace elements

Identifiers

PMID32791343
PMCPMC7689512
OpenAlexW3035160113

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.