Although there was no statistically significant differences in survival related to KRAS mutation status in our study (patients with KRAS mutations vs those with wild-type KRAS: 18.1 vs 8.1 months, p = 0.1), some studies demonstrated that the presence of KRAS mutations in tumor have a significant worse impact on survival time and response of treatment.[29] It is still difficult to conclude that the presence of KRAS mutations relates with the prognosis of advanced PDAC. This evidence concerns the gene KRAS and neoplasm.