Evidence map›Paper›PMID 41186643›Full record

ArticleAnnals of surgical oncology2026

KRAS Mutation Allele Frequency Dynamics in Plasma Extracellular Vesicles: Association with Survival in Localized Pancreatic Adenocarcinoma.

Asmita Chopra, Hong-Zhang He, Jadranka Milosevic, Nikhil Tirukkovalur, Rudy El Asmar, Ibrahim Nassour, Geoffrey Nunns, Mingxi Chen, Jiaqi Chen, Siyu Jiang and 7 more

Abstract read
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In one paragraph

Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

17 authors.

Asmita Chopra *Department of Surgery, Division of Surgical Oncology Pittsburgh, Digestive Disorder Clinic, University of Pittsburgh, Pittsburgh, PA, USA.
Hong-Zhang He *Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.
Jadranka MilosevicDepartment of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.
Nikhil TirukkovalurDepartment of Surgery, Division of Surgical Oncology Pittsburgh, Digestive Disorder Clinic, University of Pittsburgh, Pittsburgh, PA, USA.
Rudy El AsmarDepartment of Surgery, Division of Surgical Oncology Pittsburgh, Digestive Disorder Clinic, University of Pittsburgh, Pittsburgh, PA, USA.
Ibrahim NassourDepartment of Surgery, University of Florida, Gainesville, FL, USA.
Geoffrey NunnsDepartment of Surgery, Division of Surgical Oncology Pittsburgh, Digestive Disorder Clinic, University of Pittsburgh, Pittsburgh, PA, USA.
Mingxi ChenDepartment of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.
Jiaqi ChenDepartment of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.
Siyu JiangDepartment of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.
Aatur D SinghiDepartment of Surgery, Division of Surgical Oncology Pittsburgh, Digestive Disorder Clinic, University of Pittsburgh, Pittsburgh, PA, USA.
Anwaar SaeedDepartment of Medical Oncology, University of Pittsburgh, Pittsburgh, PA, USA.
Janie ZhangDepartment of Medical Oncology, University of Pittsburgh, Pittsburgh, PA, USA.
Kenneth LeeDepartment of Surgery, Division of Surgical Oncology Pittsburgh, Digestive Disorder Clinic, University of Pittsburgh, Pittsburgh, PA, USA.
Amer ZureikatDepartment of Surgery, Division of Surgical Oncology Pittsburgh, Digestive Disorder Clinic, University of Pittsburgh, Pittsburgh, PA, USA.
Si-Yang Zheng *Department of Biomedical Engineering, Carnegie Mellon University, Pittsburgh, PA, USA.
Alessandro Paniccia *Department of Surgery, Division of Surgical Oncology Pittsburgh, Digestive Disorder Clinic, University of Pittsburgh, Pittsburgh, PA, USA. panicciaa2@upmc.edu.

Funding

Lipid nanoprobe integrated microdevice for extracellular vesicle isolation and duplex sequencing based mutation detection for non-invasive lung cancer diagnosisR01CA230339 · NCI · PENNSYLVANIA STATE UNIVERSITY, THE · PI ZHENG, SIYANG · 2018 to 2023
$1.9M
Develop a rapid, efficient and low cost extracellular vesicles isolation method toward non-invasive non-small cell lung cancer molecular analysisR43CA228847 · NCI · CAPTIS DIAGNOSTICS · PI HE, HONGZHANG · 2018 to 2019
$357k
NCI NIH HHS R01 CA230339NCI NIH HHS R43 CA228847NIH HHS NIH/NCI R01CA230339NIH HHS NIH/NCI R43CA228847-01A1
6 · The paper itself

Abstract

backgroundPancreatic ductal adenocarcinoma (PDAC) lacks consistent biomarkers to monitor treatment response and predict survival. Metabolically active extracellular vesicles (EVs) carrying tumor-specific KRAS mutations offer promise as disease-specific biomarkers. PATIENTS AND

methodsInformed by genomic profiling of tumor tissue, plasma samples were prospectively collected from 44 patients, with confirmed KRAS-mutated PDAC, undergoing neoadjuvant therapy (NAT) followed by surgery between 2019 and 2021. Samples were obtained at diagnosis, post-NAT, and 1 month post surgery. EVs were isolated using lipid nanoprobe technology, and EV-associated KRAS mutations were detected using droplet digital polymerase chain reaction (ddPCR). Patients were grouped on the basis of temporal changes in EV-associated KRAS mutation allele frequency (MAF): no KRAS detected (ND), decreasing MAF (DD), and increasing MAF (ID).

resultsAmong 44 patients, 29 (65.9%) were ND, 8 (18.2%) DD, and 7 (15.9%) ID. Detectable EV-associated KRAS MAF was found in 21%, 30%, and 50% of patients with stages I, II, and III PDAC. No significant differences were noted in demographic or clinical variables (p > 0.05). The ND group had the longest restricted mean disease-free survival (rmDFS: 31.2 months), followed by DD (27.8 months) and ID (9.8 months; p = 0.010). Similarly, restricted mean overall survival (rmOS) was longest in the ND (40.3 months), followed by DD (35.7 months) and ID (17.7 months; p = 0.012). On multivariable analysis, increasing EV-KRAS MAF (ID group) independently predicted inferior rmDFS [hazard ratio (HR): 6.14; p = 0.001] and rmOS (HR: 6.95; p = 0.002).

conclusionsTemporal increase of EV-KRAS MAF is a significant predictor of reduced DFS and OS in PDAC. Integrating EV-KRAS mutation allele frequency dynamics analysis with current biomarkers such as carbohydrate antigen 19-9 (CA19-9) could improve treatment monitoring and survival prognostication.

Indexed as

Biomarkers, TumorCarcinoma, Pancreatic DuctalExtracellular VesiclesGene FrequencyMutationPancreatic NeoplasmsProto-Oncogene Proteins p21(ras)AdenocarcinomaAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedPrognosisProspective StudiesBiomarkers, TumorKRAS protein, humanProto-Oncogene Proteins p21(ras)AdenocarcinomaExtracellular vesicleKRAS mutationMutation allele frequencyPancreatic cancerSurvival outcome

Identifiers

PMID41186643
PMCPMC12681068

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