Utility of Assessing the Number of Mutated KRAS, CDKN2A, TP53, and SMAD4 Genes Using a Targeted Deep Sequencing Assay as a Prognostic Biomarker for Pancreatic Cancer
Abstract
OBJECTIVES: KRAS, CDKN2A, TP53, and SMAD4 have been recognized as major driver genes in pancreatic carcinogenesis. We examined somatic mutations in 50 cancer-related genes, including the four above-mentioned driver genes, to identify genomic biomarkers for predicting the outcome of patients with pancreatic cancer. METHODS: Genomic DNA was extracted from fresh-frozen specimens obtained from 100 patients with pancreatic cancer who had undergone a pancreatectomy with curative intent. The mutation profile was obtained using a single targeted deep sequencing assay performed with a next-generation sequencer, and the associations with clinicopathological factors were analyzed. RESULTS: Mutations in the KRAS, CDKN2A, TP53, and SMAD4 genes were detected in 96% (96/100), 42% (42/100), 13% (13/100), and 7% (7/100) of all patients, respectively. Among the 71 patients who underwent a radical operation followed by adjuvant chemotherapy, patients with fewer mutations among the four driver genes tended to have a better outcome. A multivariate analysis using the Cox proportional hazard model showed that the presence of 0 to 2 mutated driver genes was an independent predictor of a better overall survival (hazard ratio for death, 0.20; P = 0.0040). CONCLUSIONS: The number of mutated driver genes assessed using a targeted deep sequencing assay was a promising prognostic biomarker for pancreatic cancer.
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Number of mutated driver genes, rather than mutations in individual genes, was significantly associated with overall survival.
“Survival analyses demonstrated that the number of mutated driver genes, rather than mutations in individual genes, was significantly associated with overall survival.”
From Significance of TP53, CDKN2A, SMAD4 and KRAS in Pancreatic Cancer (2024) · cites this paper as [100]
Patients with 0 to 2 mutated genes had substantially longer median overall survival compared to those with 3 mutated genes.
“Patients with 0 to 2 mutated genes had a substantially longer median overall survival compared to those with 3 mutated genes [100].”
From Significance of TP53, CDKN2A, SMAD4 and KRAS in Pancreatic Cancer (2024) · cites this paper as [100]
Mutations in CDKN2A, TP53 and SMAD4 were also prevalent, occurring in 7-42% of cases.
“While mutations in CDKN2A, TP53 and SMAD4 were also prevalent, occurring in 7–42% of cases, nonsynonymous mutations in other cancer-related genes were rare.”
From Significance of TP53, CDKN2A, SMAD4 and KRAS in Pancreatic Cancer (2024) · cites this paper as [100]
KRAS has been the most frequently mutated gene, identified in 96% of cases.
“Hayashi et al. revealed that KRAS has been the most frequently mutated gene, identified in 96% of cases.”
From Significance of TP53, CDKN2A, SMAD4 and KRAS in Pancreatic Cancer (2024) · cites this paper as [100]
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- Authors
- Hayashi, H., Kohno, T., Ueno, H., Hiraoka, N., Kondo, S., Saito, M., Shimada, Y., Ichikawa, H., Kato, M., Shibata, T., Morizane, C., Sakamoto, Y., Shimada, K., Komatsu, Y., Sakamoto, N., & Okusaka, T.
- Affiliations
- Hokkaido University (JP)
- National Cancer Center Research Institute (JP)
- Hokkaido University Hospital (JP)
- National Cancer Center Hospital (JP)
- National Cancer Centre Japan (JP)
- Corresponding author
- Hayashi, Hideyuki
- Ueno, Hideki
- Kondo, Shunsuke
- Morizane, Chigusa
- Sakamoto, Yasunari
- Shimada, Kazuaki
- Okusaka, Takuji
- ORCID
- Venue
- Pancreas
- Published
- 2017-03
- Volume
- 46
- Issue
- 3
- Pages
- 335-340
- ISSN
- 0885-3177 (ISSN-L)
- OpenAlex
- W2573972894
- Cited by
- 88
- References
- 29
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 6 · 2023: 9 · 2022: 15 · 2021: 12 · 2020: 16 · 2019: 12 · 2018: 6 · 2017: 6
- FWCI
- 4.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pancreas (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Japan Society for the Promotion of Science (26461039)
- Topics
- Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
- Health Sciences › Medicine › Surgery › Cholangiocarcinoma and Gallbladder Cancer Studies
- Keywords
- pancreatic cancer, somatic mutations, KRAS, CDKN2A, TP53, SMAD4, driver genes, prognostic factors, targeted deep sequencing, overall survival, adjuvant chemotherapy, pancreatic resection
- MeSH terms
- Combined Modality Therapy, Humans, Mutation, Pancreatic Neoplasms, Prognosis, Biomarkers, Tumor, Multivariate Analysis, Proportional Hazards Models, Survival Analysis, Tumor Suppressor Protein p53, Proto-Oncogene Proteins p21(ras), Outcome Assessment, Health Care, Cyclin-Dependent Kinase Inhibitor p16, Smad4 Protein, High-Throughput Nucleotide Sequencing
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