Retrospective study of KRAS allelic variants in biliary tract cancers

Biliary tract cancers (BTCs) contain several actionable molecular alterations. KRAS allelic variants are found in 20% to 30% of BTCs, and multiple KRAS inhibitors are currently under clinical investigation. A retrospective cohort study of 7457 BTC patients in Canada and the United States, found that KRAS allelic variants were common, but prevalence was considerably higher among patients with perihilar and extrahepatic cholangiocarcinomas. The most common allelic variants were G12D, G12V, and Q61H, with G12D having the highest median overall survival (25.1 months) compared with Q61H (22.8 months) and G12D (17.8 months). The authors conclude that KRAS allelic variants within BTCs are potentially actionable genomic alterations.