{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T23:37:02Z","timestamp":1777246622397,"version":"3.51.4"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Marianne & Teodor Dauenhauer Stiftung"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Pancreatic cancer remains one of the most lethal malignancies, with limited integration of precision oncology into routine clinical care. We present a unique case of a RAS wild-type, MSI-H, TMB-H pancreatic ductal adenocarcinoma harboring a TPM3-NTRK1 fusion, monitored through 13 serial liquid biopsies over 3\u2009years. Dynamic changes in NTRK1-fusion allele frequency, tumor mutational burden, and the emergence of an NTRK1 resistance mutation guided finely tuned, situation-adapted therapeutic adjustments: rapid disease control with targeted NTRK inhibition followed by durable remission under immune checkpoint blockade. This case highlights the power of comprehensive molecular profiling and high-frequency ctDNA monitoring to capture tumor evolution and minimal residual disease. Importantly, it further demonstrates how MRD-guided surveillance enables a precise balance between fast-acting targeted therapy and the sustained effects of immunotherapy, providing a blueprint for individualized, context-driven treatment strategies in rare molecular subtypes of pancreatic cancer.<\/jats:p>","DOI":"10.1093\/oncolo\/oyag108","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T12:45:05Z","timestamp":1774701905000},"source":"Crossref","is-referenced-by-count":0,"title":["Minimal residual disease assessment through ctDNA facilitates tailored immunotherapy in MSI-high, NTRK1-fusion pancreatic adenocarcinoma"],"prefix":"10.1093","volume":"31","author":[{"given":"Sarah","family":"Rohlfing","sequence":"first","affiliation":[{"name":"Clinic for Gastroenterology, Hemato-Oncology, Pneumonology, Infectiology, and Intensive Care Medicine, RKH F\u00fcrst-Stirum-Klinik Bruchsal , 76646,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilyana","family":"Vladimirova","sequence":"additional","affiliation":[{"name":"Department for Hematology, Oncology, and Palliative Medicine, SLK-Clinics Heilbronn GmbH , 74078,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Berger","sequence":"additional","affiliation":[{"name":"Department for Hematology, Oncology, and Palliative Medicine, SLK-Clinics Heilbronn GmbH , 74078,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvia","family":"Bochum","sequence":"additional","affiliation":[{"name":"Department for Hematology, Oncology, and Palliative Medicine, SLK-Clinics Heilbronn GmbH , 74078,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrijela","family":"Otmacic","sequence":"additional","affiliation":[{"name":"Department for Hematology, Oncology, and Palliative Medicine, SLK-Clinics Heilbronn GmbH , 74078,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlene","family":"Wei\u00df","sequence":"additional","affiliation":[{"name":"Department for Hematology, Oncology, and Palliative Medicine, SLK-Clinics Heilbronn GmbH , 74078,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bence","family":"Sipos","sequence":"additional","affiliation":[{"name":"Qualipath\u2014Practice for Pathology and Molecular Pathology , Stuttgart, 70176,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saskia","family":"Biskup","sequence":"additional","affiliation":[{"name":"Center for Human Genetics T\u00fcbingen , T\u00fcbingen, 72076,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marion","family":"Klaum\u00fcnzer","sequence":"additional","affiliation":[{"name":"Center for Human Genetics T\u00fcbingen , T\u00fcbingen, 72076,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7999-4359","authenticated-orcid":false,"given":"Uwe M","family":"Martens","sequence":"additional","affiliation":[{"name":"Department for Hematology, Oncology, and Palliative Medicine, SLK-Clinics Heilbronn GmbH , 74078,","place":["Germany"]},{"name":"MOLIT Institute for Personalized Medicine , Heilbronn, 74076,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,30]]},"reference":[{"key":"2026042618471484300_oyag108-B1","doi-asserted-by":"publisher","first-page":"16425","DOI":"10.1038\/s41598-020-73525-y","article-title":"The actual 5-year survivors of pancreatic ductal adenocarcinoma based on real-world data","volume":"10","author":"Bengtsson","year":"2020","journal-title":"Sci 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