(1) Background: Pancreatic ductal adenocarcinoma (PDAC) has low survival rates despite treatment advancements. Aim: This study aims to show how molecular profiling could possibly guide personalized treatment strategies, which may help improve survival outcomes in patients with PDAC. (2) Materials and Methods: A retrospective analysis of 142 PDAC patients from a single academic center was conducted. Patients underwent chemotherapy and next-generation sequencing for molecular profiling. Key oncogenic pathways were identified using the Reactome pathway database. Survival analysis was performed using Kaplan–Meier curves and Cox Proportional Hazards Regression. (3) Results: Patients mainly received FOLFIRINOX (n = 62) or gemcitabine nab-paclitaxel (n = 62) as initial chemotherapy. The median OS was 13.6 months. Longer median OS was noted in patients with NOTCH (15 vs. 12.3 months,p= 0.007) and KIT pathway mutations (21.3 vs. 12.12 months,p= 0.04). Combinatorial pathway analysis indicated potential synergistic effects on survival. In the PFS, PI3K pathway (6.6 vs. 5.7 months,p= 0.03) and KIT pathway (10.3 vs. 6.2 months,p= 0.03) mutations correlated with improved PFS within the gemcitabine nab-paclitaxel subgroup. (4) Conclusions: Molecular profiling could play a role in PDAC for predicting outcomes and responses to therapies like FOLFIRINOX and gemcitabine nab-paclitaxel. Integrating genomic data into clinical decision-making can benefit PDAC treatment, though further validation is needed to fully utilize precision oncology in PDAC management.
（1）背景：尽管治疗手段不断进步，胰腺导管腺癌（PDAC）的生存率仍然较低。目的：本研究旨在探讨分子谱分析如何可能指导个体化治疗策略，从而有助于改善PDAC患者的生存结局。（2）材料与方法：对来自单一学术中心的142例PDAC患者进行了回顾性分析。患者均接受化疗及用于分子谱分析的下一代测序。利用Reactome通路数据库识别关键致癌通路。采用Kaplan-Meier曲线和Cox比例风险回归模型进行生存分析。（3）结果：患者初始化疗方案主要为FOLFIRINOX（n=62）或吉西他滨联合白蛋白结合型紫杉醇（n=62）。中位总生存期为13.6个月。携带NOTCH通路突变（15个月 vs. 12.3个月，p=0.007）及KIT通路突变（21.3个月 vs. 12.12个月，p=0.04）的患者中位总生存期更长。组合通路分析提示通路突变可能对生存期产生协同效应。在无进展生存期方面，PI3K通路突变（6.6个月 vs. 5.7个月，p=0.03）和KIT通路突变（10.3个月 vs. 6.2个月，p=0.03）与吉西他滨联合白蛋白结合型紫杉醇亚组患者的无进展生存期改善相关。（4）结论：分子谱分析在PDAC中可能具有预测FOLFIRINOX和吉西他滨联合白蛋白结合型紫杉醇等治疗方案疗效及预后的作用。将基因组数据整合到临床决策中有助于改善PDAC治疗，但需进一步验证以充分发挥精准肿瘤学在PDAC管理中的潜力。
肿瘤(癌症)患者之家