Construction and Maintenance of a Precision Subtyping-Based Clinical Cohort for Targeted Therapy in KRAS-Mutant Pancreatic Cancer

Pancreatic cancer is one of the most aggressive tumors in the digestive system, often referred to as the "king of cancers". Globally, its incidence and mortality rank 12th and 7th among all malignant tumors. According to the American Cancer Society, pancreatic cancer is projected to become the second leading cause of cancer-related death in the US by 2030.

KRAS gene mutations are the most common genetic alterations in pancreatic cancer, occurring in approximately 90% of patients, with subtypes such as G12D, G12V, and G12R being particularly prevalent. Conventional chemotherapy and radiotherapy offer limited efficacy and are associated with significant side effects.

With advances in precision medicine, targeted therapy has emerged as a promising treatment strategy. Substantial progress has been made in developing KRAS-targeted drugs, some of which have entered clinical trials and shown encouraging results. However, due to the complexity and heterogeneity of KRAS mutations, patient responses to targeted therapy vary significantly. Therefore, it is essential to establish a prospective cohort study to comprehensively evaluate the efficacy and safety of KRAS-targeted therapies and inform clinical decision-making.

We aim to construct a clinical cohort for KRAS-mutant pancreatic cancer patients undergoing targeted therapy, with the goal of building a database system aligned with both clinical practice and research needs. This study consists of two components:

1. Designing and implementing a database tailored to real-world clinical scenarios, retrospectively collecting clinical data from pancreatic tumor patients treated at the Shanghai Pancreatic Cancer Institute and multiple domestic and international centers, thereby establishing a real-world evidence (RWE) database;
2. Prospectively collecting clinical information from pancreatic cancer patients treated at the same institutions, with regular updates and maintenance of the pancreatic tumor RWE database.

Inclusion Criteria:

• No restrictions on age, gender, or performance status score;

  • Pathologically or cytologically confirmed pancreatic adenocarcinoma; ③ Known KRAS mutation subtype and has received treatment with KRAS-targeted agents;

    ④ Able to comply with the study visit schedule requirements;

    ⑤ Voluntarily participate and sign the informed consent form.

Exclusion Criteria:

• Non-neoplastic pancreatic lesions;

  • Non-primary pancreatic neoplastic lesions; ③ Unable to comply with the study visit schedule requirements; ④ Refuse to participate and sign the informed consent form.

This study is a multicenter real-world data collection research . It aims to establish a multicenter real-world evidence (RWE) database for KRAS-targeted therapy in pancreatic cancer. The study will retrospectively collect clinical data of pancreatic cancer patients with KRAS mutations previously diagnosed and treated at the Shanghai Pancreatic Cancer Institute , and prospectively collect clinical information from similar patients treated at the same institute. The database will be regularly updated and maintained.

Clinical data of KRAS-mutant pancreatic cancer patients from domestic and international pancreatic tumor centers will be collected and periodically updated. Identifiable personal information such as ID numbers and names will be removed to enable multicenter collaboration and ensure patient privacy, with the goal of generating reliable evidence-based medical data .