Bach Ardalan
This case report describes a 73-year-old male with pancreatic adenocarcinoma expressing a KRAS G12R mutational variant among KRAS-mutated PDACs. The patient demonstrated a response to treatment with a combination of gemcitabine, nab-paclitaxel, and the MEK inhibitor, Cobimetinib. Imaging revealed resolution of abdominal distention and the CA 19-9 laboratory marker regressed into a normal range. Molecular profiling revealed distinct differences between G12R PDAC tumors, including lower PD-L1 expression, immune infiltration, and metabolic markers in G12R tumors, suggesting reduced immunogenicity. However, the G12R population showed the highest overall survival among codon 12 variants. This case highlights the potential vulnerability of G12R PDAC to targeted MEK inhibition alongside standard chemotherapy, leading to clinical benefits. Further investigation into the unique biology of G12R tumors may uncover novel therapeutic strategies.
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