CtDNA-guided Maintenance Therapy in Pancreatic Cancer

Inclusion Criteria:

• Age ≥18 years, male or female

• Histologically or cytologically confirmed primary diagnosis of pancreatic ductaladenocarcinoma (PDAC)

• No evidence of distant metastasis (M0)

• Underwent R0 radical resection within 3 months prior to enrollment

• ECOG performance status of 0-1

• Life expectancy ≥3 months

• Patient or legal guardian is able to understand the study requirements and willingto provide written informed consent

Exclusion Criteria:

• Prior history of radiotherapy, chemotherapy or surgical treatment for pancreaticcancer

• Concurrent severe organ dysfunction or hematologic disorders

• Tumor involvement of celiac axis or superior mesenteric artery, locally advanceddisease, or presence of distant metastases

• Poor general condition deemed unable to tolerate chemotherapy

• History of other malignancies within past 5 years (except adequately treatedcarcinoma in situ of cervix or basal cell carcinoma of skin)

• Any severe or uncontrolled systemic disease that may affect risk/benefit assessment,including but not limited to: uncontrolled hypertension, active hepatitis B or Cinfection, HIV infection

• Patient or guardian unable to comprehend study objectives and requirements

• Any other condition that in the investigator's judgment would make the patientunsuitable for study participation