ASCO GI 2026: Precision Medicine Gains Momentum in Pancreatic Cancer
Key Points
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Comprehensive biomarker testing, including tumor next-generation sequencing (NGS), cell-free DNA, and germline testing, is guideline-recommended in pancreatic cancer.
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Repeat sampling may be required because of low tumor cellularity.
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Patient preferences remain central to care, but early supportive discussions and evolving targeted therapies may help address fears and hesitations around treatment.
Precision oncology and biomarker testing are reshaping pancreatic cancer care. Fiyinfolu Balogun, MD, PhD, and Wungki Park, MD, MS, both of Memorial Sloan Kettering Cancer Center, met at the 2026 ASCO Gastrointestinal (GI) Cancers Symposium to discuss how these advances are influencing clinical practice.
Dr. Park emphasized that comprehensive molecular profiling is essential for all patients with pancreatic cancer. He recommended performing tumor tissue NGS and cell-free DNA testing, alongside germline testing from blood or buccal swabs. Because pancreatic tumors often have dense stroma and low cellularity, initial biopsies may not provide enough DNA, making repeat testing necessary. He also stressed that KRAS–wild-type results require confirmation to ensure accurate clinical interpretation.
In cases where actionable mutations, such as KRAS G12C, are identified, targeted therapies or clinical trials may be available, Dr. Park said.
Although fear and stigma surround chemotherapy, Dr. Park shared that oncologists should support hesitant patients while respecting their wishes. He said he often suggests that they try an initial course of treatment. Looking ahead, Dr. Park is hopeful about KRAS- and RAS-targeted therapies that may reduce reliance on traditional chemotherapy.