Kullmanna F et al. – KRAS mutation in codon 12 may be associated with reduced survival compared to KRAS wild type. The role of KRAS mutations for cetuximab therapy in pancreatic cancer warrants further investigation in larger trials to exclude an epiphenomenon.

• Multicenter phase II trial
• 64 patients with metastatic pancreatic cancer were treated with cetuximab in combination with gemcitabine and oxaliplatin until disease progression
• Analyses of EGFR pathway, including KRAS mutations, could be performed in 25 patients
• Analyses were carried out following microdissection of the tumor

• Fourteen (56%) of the 25 patients examined harbored a point mutation in codon 12 of the KRAS gene
• No differences between the groups were noted in median progression–free survival (104 days in KRAS wild–type patients vs 118 days in patients with KRAS mutations)
• OS was longer in wild–type patients compared to patients with KRAS mutations (263 vs. 162 days), but difference did not reach statistical significance
• Further analysis of our clinical phase II trial showed that the presence of a rash was significantly correlated with OS