Prognostic Value of KRAS Mutations in the Peripheral Blood of Patients with Pancreatic Cancer: a Systematic Review and Meta-analysis

KRAS mutations are common in patients with pancreatic cancer. However, the prognostic significance of KRAS mutations in peripheral blood of pancreatic cancer patients remains uncertain. Thus, this meta-analysis was conducted to assess the prognostic value of KRAS mutations in peripheral blood samples of these patients. We conducted a comprehensive search of articles listed in the PubMed, EMBASE literature databases, and Web of Science databases. The search covered the publication period from database inception to October 10, 2020. Twenty-eight studies met the inclusion criteria and 2,006 patients were pooled for the meta-analysis. The average positive rate of KRAS mutations in peripheral blood was 44.9%. Our meta-analysis indicated that KRAS mutations in peripheral blood have a negative prognostic value in pancreatic cancer [hazard ratio (HR), 2.42; 95% confidence interval (CI), 1.95-3.01]. Moreover, further subgroup analyses by stages of pancreatic cancer and KRAS target mutations all revealed that pancreatic cancer patients with the KRAS mutations had inferior overall survival. KRAS mutations in peripheral blood have a negative prognostic value in pancreatic cancer.