Pancreatic cancer with its associated infaust prognosis urgently needs better early detection of disease, especially for screening of high risk individuals. Despite early promise and theoretical considerations, however, KRAS mutional analysis of cfDNA seems not a way forward here. A more multifaceted panel of mutational spectrum biomarkers study (KRAS, TP53, SMAD4, P16, EGFR GNAS, MENN1, DAXX, VHL and in combination of pancreatic cancer specific STR markers) along with epigenetic alterations in cfDNA in pancreatic cancer patients may still provide a successful prognostic and diagnostic avenue, but generally speaking cfDNA does not appear very promising direction. Hence focus should now be directed to alternative methodology.

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Journal Translational Cancer Research

Provenance: This is a Guest Commentary commissioned by Xiaotian Sun (Department of Internal Medicine, Clinic of August First Film Studio, Beijing, China).
Comment on: Le Calvez-Kelm F, Foll M, Wozniak MB, et al. KRAS mutations in blood circulating cell-free DNA: a pancreatic cancer case-control. Oncotarget 2016;7:78827-40.

Narayanan, V, Konstantinov, S.R, & Peppelenbosch, M.P. (2017). Mutations in KRAS: are they a valid biomarker for pancreatic ductal adenocarcinomas diagnosis?. Translational Cancer Research (Vol. 6, pp. S72–S77). doi:10.21037/tcr.2017.02.46