S2433: Randomized phase III study of second-line chemotherapy with or without panitumumab for KRAS wild type, locally advanced, or metastatic pancreatic adenocarcinoma.

作者：Rachael A. Safyan, Sarah Colby, Harshabad Singh, Katherine A. Guthrie, Virginia Sun, Raymond Wadlow, Olumide B. Gbolahan, Davendra Sohal, Andrew M. Lowy, Syed A. Ahmad, E. Gabriela Chiorean, Philip Agop Philip · 发表于：Journal of Clinical Oncology · 年份：2026 · DOI：10.1200/jco.2026.44.16_suppl.tps4264 · 研究领域：Pancreatic and Hepatic Oncology Research、HER2/EGFR in Cancer Research、Cancer Genomics and Diagnostics

TPS4264 Background: Pancreatic ductal adenocarcinoma (PDA) is characterized by driver mutations in KRAS , TP53 , CDKN2A , and SMAD4 . KRAS wild type (WT) tumors, present in 5-10% of PDA, often harbor alternative mitogen-activated protein kinase (MAPK) pathway drivers or other targetable molecular alterations (e.g., microsatellite instability [MSI-high], DNA damage repair mutations), enabling targeted therapy in approximately 30% of cases; however, most lack actionable drivers and require a tailored treatment approach. EGFR is overexpressed in 30%-70% of PDA. Prior studies of EGFR-targeted therapy demonstrated modest overall survival (OS) benefit in unselected populations, with retrospective analyses suggesting benefit confined to KRAS WT PDA. Recent data showed survival benefit from the anti-EGFR antibody nimotuzumab when added to 1 st line gemcitabine vs gemcitabine alone in KRAS WT PDA. These findings provide a strong rationale to evaluate anti-EGFR mAb in combination with multi-agent chemotherapy in KRAS WT PDA in the United States. Methods: This randomized (1:1) phase III study will enroll 94 pts to investigator choice 2 nd -line chemotherapy – 5 fluorouracil (5FU) plus irinotecan or nanoliposomal irinotecan following 1 st -line gemcitabine-based therapy, or gemcitabine plus nab-paclitaxel following 1 st -line 5FU-based therapy – with or without panitumumab. Eligibility requires KRAS WT and BRAF V600E WT status by tumor tissue-based next-generation sequencing and no known...