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Understanding your tumor biology is key to finding the right treatment for pancreatic cancer.
Identifying mutations, or changes in a cell’s DNA, can help doctors understand how cancer might grow and spread. Some of the most important mutations doctors look for are in the RAS family of genes. This family of genes plays a critical role in regulating cell growth and division. The most common subtype, KRAS, is linked to the development of many cancers, including pancreatic cancer.
What You Need to Know About KRAS
Scientists have found that around 30% of solid tumors in people with cancer have mutated KRAS genes. Specifically for the most common type of pancreatic cancer, pancreatic ductal adenocarcinoma, more than 90% of tumors are thought to have a KRAS mutation.
When these genes function normally, they act like stop-and-go signals for healthy cell activity. But when genes like KRAS mutate, it’s as if the signal gets stuck on “go.” This malfunction can drive the growth of cancer cells.
For decades, RAS mutations were considered “undruggable,” meaning there was no effective way to target them with treatments. But groundbreaking new research is changing that.
We’re moving closer to a world where every patient with pancreatic cancer will be treated with a precision medicine approach. The emergence of RAS-targeted therapies has the potential to revolutionize treatment for patients with pancreatic cancer.
How Do I Know if I Have a KRAS Mutation?
Every patient with pancreatic cancer is different – and your unique biology can help determine which treatment you should receive. PanCAN strongly recommends that all pancreatic cancer patients get biomarker testing of their tumor tissue to help determine the best treatment options. You can learn whether you have a KRAS mutation through biomarker testing. Biomarker testing will also tell you the specific KRAS mutation your tumor has.
What Is Biomarker Testing?
Biomarker testing of tumor tissue tells you about the biology of your tumor. It is also sometimes called molecular profiling, tumor testing or genomic testing.
How Does Biomarker Testing Work?
- 1. A small tissue sample is collected through a biopsy or surgery.
- 2. The sample is analyzed. It can show changes in the tumor's genes or proteins.
- 3. Your doctor reviews the results and may be able to use this information to make treatment decisions.
How Do I Get Biomarker Testing?
Talk to your healthcare team about biomarker testing and genetic testing for inherited mutations. This is usually the fastest and easiest way to get the answers you need.
If testing isn't available near you, you may qualify for PanCAN's Know Your Tumor® precision medicine service, which offers free genetic and biomarker testing.
Contact PanCAN Patient Services. We can help you understand your options and connect you with National Cancer Institute (NCI) designated hospitals that specialize in pancreatic cancer, which can open the door for testing.
Get on the Right Track
From diagnosis through every treatment decision, it's important for patients with pancreatic cancer to get on the Right Track for the best possible outcome. PanCAN Patient Services can provide free, personal one-to-one support and resources at every step.
The Right Track for You
Right Team
Find experts and centers with experience treating patients with pancreatic cancer. PanCAN Patient Services is here to help with your search.
Right Tests
Ask your care team about genetic and biomarker testing to understand if you have KRAS or other mutations that might help guide your care plan.
Right Treatments
Ask your doctor about clinical trials. Some patients may be eligible for clinical trials testing innovative drugs targeting mutations identified through testing.
PanCAN Patient Services is here to help at every step.
Contact PanCAN Patient Services for more information about testing and clinical trials and to help determine the Right Track for you.
Learn More About RAS
Read “Five Things to Know About Targeting Mutant KRAS in Pancreatic Cancer.”
What are RAS mutations?
RAS mutations are changes in the RAS family of genes (KRAS, NRAS, and HRAS), which regulate cell growth and division. Mutations in RAS can cause cancer cells to grow uncontrollably, leading to cancer. RAS mutations are typically somatic mutations, meaning they occur in tumor cells during a person’s lifetime and are not passed down genetically.
Back to topHow common are RAS mutations in pancreatic cancer?
RAS mutations, particularly in the KRAS gene, are found in over 90% of pancreatic cancer cases. KRAS mutations are one of the most studied genetic drivers of this disease.
Back to topWhat is KRAS and why is it important?
KRAS is a gene that plays a central role in cell signaling pathways. Mutations in KRAS can “switch on” signals for constant cell growth, driving tumor formation and progression. Identifying a KRAS mutation can guide treatment strategies and eligibility for clinical trials.
Back to topDoes biomarker testing include testing for KRAS mutations?
Yes, biomarker testing includes testing for KRAS mutations and other genetic changes commonly found in pancreatic cancer.
Back to topAre there treatments specifically targeting KRAS mutations?
Historically, RAS mutations were considered “undruggable.” However, recent advances have led to the development KRAS inhibitors like KRAZATI® (adagrasib) and LUMAKRAS® (sotorasib). These two drugs may be available for the small percentage of people with pancreatic cancer who have a KRAS G12C mutation. Even though these two drugs are approved for people with lung and/or colorectal cancer, doctors may be able to prescribe them for people with pancreatic cancer who meet certain guidelines. This is why it is important to know your RAS status, so you can have informed conversations with your doctor about other treatment options that may be available to you.
Research into other KRAS-targeted therapies is ongoing.
Back to topCan I participate in a clinical trial for therapies targeting KRAS mutations?
Many clinical trials focus on investigational treatments for KRAS-driven cancers. Our goal is to empower patients to consider all of their treatment options, with clinical trials being an important one. PanCAN Patient Services Case Managers can search for trials, answer questions, help to navigate the enrollment process and more. Or use PanCAN's Clinical Trial Finder to conduct a search on your own. A Case Manager can then help you narrow your results based on your specific tumor biology.
Back to topWhat should I do if my tumor has a KRAS mutation?
A positive test for a KRAS mutation can guide treatment options. Your doctor may recommend:
- 1. Standard therapies.
- 2. Therapies tailored to your tumor profile.
- 3. Participation in clinical trials, potentially targeting KRAS mutations.
Can biomarker testing help even if I've already started treatment?
Yes. Biomarker testing will help you and your doctor know what treatment and clinical trial options may be appropriate for future decisions.
Back to topIf I do have a KRAS mutation, am I guaranteed to get on a clinical trial?
Because understanding KRAS mutations is so important to understanding pancreatic cancer, there are many clinical trials studying investigational treatments that target KRAS. Every clinical trial is different and each has its own requirements to join. Ability to enroll may depend on things like general health, ability to handle the treatment, lab results and more. Your medical team can answer questions you have about clinical trial eligibility and enrollment.
Contact PanCAN Patient Services for more information on clinical trials, including a free personalized clinical trial search.
Back to topShould I consider genetic testing in addition to biomarker testing?
Yes. Genetic testing can help you and your family learn more about genetic mutations that can be passed down from parent to child. While KRAS mutations are somatic (happen over a person's lifetime and can't be passed down), some mutations are inherited. These mutations, like BRCA1 and BRCA2, can increase a person's risk of developing pancreatic cancer and other cancers and can influence treatment options. Genetic testing can help family members understand their risk.
Back to topMore About Precision Medicine
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Information reviewed by PanCAN’s Scientific and Medical Advisory Board, who are experts in the field from such institutions as University of Pennsylvania, Memorial Sloan-Kettering Cancer Center, Virginia Mason Medical Center and more.
Information provided by the Pancreatic Cancer Action Network, Inc. (“PanCAN”) is not a substitute for medical advice, diagnosis, treatment or other health care services. PanCAN may provide information to you about physicians, products, services, clinical trials or treatments related to pancreatic cancer, but PanCAN does not recommend nor endorse any particular health care resource. In addition, please note any personal information you provide to PanCAN’s staff during telephone and/or email communications may be stored and used to help PanCAN achieve its mission of assisting patients with, and finding cures and treatments for, pancreatic cancer. Stored constituent information may be used to inform PanCAN programs and activities. Information also may be provided in aggregate or limited formats to third parties to guide future pancreatic cancer research and education efforts. PanCAN will not provide personal directly identifying information (such as your name or contact information) to such third parties without your prior written consent unless required or permitted by law to do so. For more information on how we may use your information, you can find our privacy policy on our website at https://pancan.org/privacy/.
