A Registry to Capture Patient Outcomes With KRAS G12R Altered Advanced Pancreatic Ductal Adenocarcinoma Treated With MEK Inhibitor-based Combination Therapy

Study Overview
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Brief Summary
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This is an observational precision oncology study designed to collect and analyze data that allows us to characterize the safety and efficacy of several different mitogen-activated protein kinase kinase inhibitor (MEKi) -based treatment strategies and the feasibility of administering MEKi combination therapies to patients with KRAS G12R mutated advanced pancreatic ductal adenocarcinoma (PDAC).

Detailed Description
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Patient medical records, obtained both retrospectively and prospectively, will be examined for results of molecular profiling obtained through standard of care testing to help understand how well KRAS G12R pancreatic patients respond to MEKi-based combination matched therapy. Patient outcome parameters including but not limited to tumor response, patient survival, and toxicity will be analyzed. Moreover, metrics will be collected to ascertain whether a future clinical trial involving a MEKi-based combination therapy is feasible to carry out.

Official Title
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A Registry to Capture Patient Outcomes With KRAS G12R Altered Advanced Pancreatic Ductal Adenocarcinoma Treated With MEK Inhibitor-based Combination Therapy

Conditions
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Pancreatic Ductal Adenocarcinoma

Intervention / Treatment
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* Other: combination therapy with no MEKi
* Drug: combination therapy with MEKi-HCQ
* Drug: combination therapy with MEKi-EGFRi
* Drug: combination therapy with MEKi.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥18 years. Diagnosis of advanced pancreatic ductal adenocarcinoma as determined by the treating physician or tumor board. Tumor must have KRAS G12R mutation, as determined by a next generation sequencing (NGS) panel or circulating tumor DNA panel of choice of the treating physician. Ability to understand a written informed consent document and the willingness to sign it. Exclusion Criteria: Age <18 years. Primary cancer diagnosis other than advanced pancreatic ductal adenocarcinoma Tumor does not have a KRAS G12R mutation.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Therapy with no MEKi<br>Subjects have advanced PDAC with KRAS G12R mutation. Subjects' tumors must have KRAS G12R mutation, as determined by a next generation sequencing (NGS) panel or circulating tumor DNA panel of choice of the treating physician. Subjects will receive therapy with no MEKi. | Other: combination therapy with no MEKi<br>* This cohort will receive combination therapy with no MEKi.<br>* Other names: mitogen-activated extracellular signal-regulated kinase inhibitor;|
| Therapy with MEKi- Hydroxychloroquine (HCQ)<br>Subjects have advanced PDAC with KRAS G12R mutation. Subjects' tumors must have KRAS G12R mutation, as determined by a next generation sequencing (NGS) panel or circulating tumor DNA panel of choice of the treating physician. Subjects will receive therapy with MEKi and HCQ. | Drug: combination therapy with MEKi-HCQ<br>* This cohort will receive combination therapy with MEKi-HCQ.<br>* Other names: mitogen-activated extracellular signal-regulated kinase inhibitor with hydroxychloroquine;|
| Therapy with MEKi- Epidermal growth factor receptor inhibitor (EGFRi)<br>Subjects have advanced PDAC with KRAS G12R mutation. Subjects' tumors must have KRAS G12R mutation, as determined by a next generation sequencing (NGS) panel or circulating tumor DNA panel of choice of the treating physician. Subjects will receive combination therapy with MEKi and EGFRi. | Drug: combination therapy with MEKi-EGFRi<br>* This cohort will receive combination therapy with MEKi-EGFRi.<br>* Other names: mitogen-activated extracellular signal-regulated kinase inhibitor with epidermal growth factor receptor inhibitor;|
| Therapy with MEKi-Other<br>Subjects have advanced PDAC with KRAS G12R mutation. Subjects' tumors must have KRAS G12R mutation, as determined by a next generation sequencing (NGS) panel or circulating tumor DNA panel of choice of the treating physician. Subjects will receive combination therapy with MEKi and a specified drug combination. | Drug: combination therapy with MEKi.<br>* This cohort will receive combination therapy with MEKi.<br>* Other names: mitogen-activated extracellular signal-regulated kinase inhibitor;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The number of subjects with no progression. | This is defined as the time from the start of treatment until six months on treatment, or disease progression, as defined by Response Evaluation Criteria in Solid Tumors (RECIST) v1.1, or death, whichever occurs first. | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The number of subjects who have a complete response. | A complete response will be determined using RECIST v1.1. | 2 years | 
| The number of subjects who have a partial response. | A partial response will be determined using RECIST v1.1. | 2 years | 
| The number of grade 3 adverse events at least possibly related to a drug. | Adverse events and serious adverse events will be classified using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5. | 2 years | 
| The number of grade 4 adverse events at least possibly related to a drug. | Adverse events and serious adverse events will be classified using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) version 5. | 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Pancreatic Ductal Adenocarcinoma, KRAS G12R mutation, Precision medicine, Retrospective Chart Review, Prospective Chart Review