{
  "abstract": "Circulating tumor DNA (ctDNA) is a minimally invasive biomarker in pancreatic ductal adenocarcinoma (PDAC), but the prognostic information added by multigene ctDNA metrics beyond KRAS and carbohydrate antigen 19-9 (CA19-9) is uncertain. In this prospective observational pilot study, 51 patients with advanced PDAC receiving 5-fluorouracil-based chemotherapy underwent 118-gene ctDNA profiling at baseline and 4 and 8 weeks after treatment initiation. ctDNA burden was summarized with variant allele frequency (VAF) metrics: Sum VAF and Top4 VAF (KRAS, TP53, CDKN2A, SMAD4). Twelve-month progression-free survival (PFS) areas under the curve were 0.816 for Top4 VAF, 0.812 for Sum VAF, 0.788 for KRAS VAF, and 0.687 for CA19-9; the Top4-KRAS difference was not statistically significant (95% confidence interval, -0.120 to 0.131). Baseline ctDNA detection and high Top4 VAF remained associated with shorter PFS and overall survival after adjustment for clinical covariates. Detectable Top4 VAF at 4 weeks was associated with shorter PFS (hazard ratio, 5.739; p < 0.001). Top4 VAF changes differed across radiologic response categories at 8 but not 4 weeks; CA19-9 showed no significant paired change. These exploratory findings suggest that baseline and early on-treatment multigene ctDNA carries prognostic information in advanced PDAC, although superiority over KRAS or CA19-9 was not established.",
  "abstract_shown": true,
  "affiliations": [
    "Targeted Therapy Branch, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Republic of Korea.",
    "Department of Laboratory Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.",
    "Center for Liver and Pancreatobiliary Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Republic of Korea.",
    "Biostatistics Collaboration Team, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Republic of Korea.",
    "Department of Public Health & AI, National Cancer Center Graduate School of Cancer Science and Policy, 323 Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Republic of Korea.",
    "IMBdx, 38 Teheran-ro 113-gil, Gangnam-gu, Seoul 06173, Republic of Korea.",
    "Department of Laboratory Medicine, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Republic of Korea.",
    "Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, 323 Ilsan-ro, Ilsandong-gu, Goyang-si 10408, Republic of Korea."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Gi Yeon Lee"
    },
    {
      "affs": [
        2
      ],
      "name": "Jung Won Chun",
      "orcid": "0000-0003-1964-7501"
    },
    {
      "affs": [
        3
      ],
      "name": "Dong-Eun Lee"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Jun-Ha Jang",
      "orcid": "0009-0002-4972-2306"
    },
    {
      "affs": [
        2
      ],
      "name": "Woo Jin Lee",
      "orcid": "0000-0003-2115-6701"
    },
    {
      "affs": [
        5
      ],
      "name": "Hwang-Phill Kim"
    },
    {
      "affs": [
        1
      ],
      "name": "Seung-Tae Lee",
      "orcid": "0000-0003-1047-1415"
    },
    {
      "affs": [
        2
      ],
      "name": "Sang Myung Woo",
      "orcid": "0000-0003-3786-4403"
    },
    {
      "affs": [
        0,
        6,
        7
      ],
      "name": "Sun-Young Kong",
      "orcid": "0000-0003-0620-4058"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dxyv63701zzx7.bib",
  "cited_by": 0,
  "doi": "10.3390/ijms27198668",
  "fulltext_url": "https://europepmc.org/articles/PMC13664952",
  "id": "dxyv63701zzx7",
  "issns": [
    "1422-0067"
  ],
  "landing_url": "https://europepmc.org/article/MED/42883913",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2730|Pancreatic and Hepatic Oncology Research"
    ]
  ],
  "openalex": "W7214673895",
  "pdf_url": "https://europepmc.org/articles/PMC13664952?pdf=render",
  "pmcid": "PMC13664952",
  "pmid": "42883913",
  "published": "2026-09-28",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/dxyv63701zzx7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:16Z",
      "native_id": "MED:42883913",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42883913"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Pancreatic and Hepatic Oncology Research",
      "subfield": "oncology"
    }
  ],
  "title": "Prognostic Value and Longitudinal Dynamics of Multigene Circulating Tumor DNA in Advanced Pancreatic Cancer Treated with 5-Fluorouracil-Based Chemotherapy.",
  "title_text": "Prognostic Value and Longitudinal Dynamics of Multigene Circulating Tumor DNA in Advanced Pancreatic Cancer Treated with 5-Fluorouracil-Based Chemotherapy.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:16Z",
  "url": "https://research.draconitic.com/paper/dxyv63701zzx7",
  "venue": "International journal of molecular sciences",
  "versions": []
}