Pancreatic ductal adenocarcinoma (PDAC) remains a highly lethal disease. Approximately 92% of patients with PDAC will die with advanced disease within 5 years of diagnosis when accounting for all disease stages.1 Despite recent incremental advances in the treatment of metastatic PDAC with 5-fluorouracil (5FU), irinotecan, oxaliplatin, and leucovorin (FOLFIRINOX) or gemcitabine plus nab-paclitaxel, median survival remains <1 year.2,3 Moreover, second-line treatment options are of limited benefit, and the use of immunotherapies and molecularly targeted drugs has proven disappointing. Widespread use of genomic analysis to identify actionable mutations in PDAC has been constrained due to challenges with tissue acquisition and the low likelihood of identifying an actionable target. Although recent studies indicate that genomic analysis is technically feasible in most patients with PDAC, more information is needed to determine whether these tumors respond to targeted therapy when actionable mutations are identified.4 This report describes a patient with PDAC whose tumor was characterized by an exon 19 deletion and who experienced a sustained response to erlotinib.
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. Fukuoka M Wu YL Thongprasert S Biomarker analyses and final overall survival results from a phase III, randomized, open-label, first-line study of gefitinib versus carboplatin/paclitaxel in clinically selected patients with advanced non–small-cell lung cancer in Asia (IPASS). J Clin Oncol 2011; 29: 2866– 2874.
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