Abstract A042: Clinicopathological and molecular profiling of pancreatic adenocarcinoma: The Moroccan experience

Abstract Background: Pancreatic adenocarcinoma is a highly aggressive and molecularly heterogeneous malignancy. This study aims to characterize, for the first time in Morocco, the relationship between clinicopathological features, mutations in KRAS, NRAS, and BRAF genes, microsatellite instability (MSI) status, and patient prognosis. Methods: This study included 63 patients with pancreatic adenocarcinoma recruited at Hassan II University Hospital, Fez. Clinicopathological and survival data were obtained from medical records. Molecular analyses of KRAS, NRAS, and BRAF mutations, as well as MSI status, were performed using the Idylla™ Biocartis platform. Associations between molecular alterations, clinicopathological parameters, and overall survival were evaluated using the Kaplan–Meier method and log-rank test. Results: The mean age of patients was 56.5 ± 12.1 years (range: 28–77). There was a slight male predominance (36 men, 57.1%; 27 women, 42.9%). At diagnosis, 54.0% of patients had localized disease and 12.7% had advanced-stage disease. KRAS mutations were detected in 8/9 patients analyzed (88.9%), and a BRAF mutation was identified in 1/10 cases. No NRAS mutations were observed. All nine patients tested for MSI were microsatellite stable (MSS). The mean overall survival was 49.2 months, with 12 deaths (19.0%) recorded during follow-up. Overall survival was significantly associated with lymph node metastasis (p = 0.02) and advanced tumor stage (p = 0.01), but not with tumor location, sex, or histological grade. Conclusion: This study provides new insights into the clinicopathological and molecular landscape of pancreatic adenocarcinoma in Morocco. Lymph node involvement and advanced tumor stage emerged as major prognostic factors, while the observed mutation profile, including a rare concomitant BRAF–KRAS mutation, highlights the need for larger molecular studies in Moroccan patients. Citation Format: Fatima El Agy, Imane Toughrai, Ouadih Moukit, Zineb Benbrahim, Laila Chbani. Clinicopathological and molecular profiling of pancreatic adenocarcinoma: The Moroccan experience [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: RAS Oncogenesis and Therapeutics; 2026 Mar 5-8; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(5_Suppl_1):Abstract nr A042.