Clinically aggressive Early-onset pancreatic ductal adenocarcinoma with KRAS wild-type status: case report

This case of Pancreatic ductal adenocarcinoma (PDAC) in a relatively young patient underscored a distinctive molecular profile that especially lacked KRAS mutations whilst featuring alterations in ERBB2, MSH3 and MUC1/MUC16, potentially indicating a unique subgroup with unique biological and treatment responses. Additionally, CA19-9 levels lying within the minimal range suggest the need to identify alternative novel biomarkers with adequate sensitivity and specificity. This is because in >80% PDAC cases with Stage II disease and upwards, CA-19-9 levels are elevated. The rarity of the present case, combined with the rapid progression despite FOLFIRINOX treatment, suggests that additional human epidermal growth factor receptor 2-targeted therapies may be necessary during disease progression.