Case report: identification of ERC1-RET fusion in a patient with pancreatic ductal adenocarcinoma

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy. Currently, treatment strategies for PDAC are limited because its molecular characteristics have not yet been clarified. Different RET fusions have been reported in diverse solid tumors, especially in non-small cell lung cancer (NSCLC) and papillary thyroid carcinoma (PTC). Multikinase inhibitors (MKIs) such as cabozantinib, vandetanib and lenvatinib, as well as selective inhibitors of RET alterations like selpercatinib (LOXO-292) and pralsetinib (BLU-667) have been approved by the Food and Drug Administration (FDA) for patients with RET fusionpositive tumors, such as thyroid cancer, renal cell, NSCLC, and so on. However, few studies have been reported about the association between RET fusions and PDAC. ERC1-RET fusion is a rare rearrangement. To date, it has only been reported in lung cancer and thyroid cancer. Studies of ERC1-RET fusion in PDAC have not yet been explored. In this study, we reported an ERC1-RET fusion in a 60-year-old female patient with PDAC. To the best of our knowledge, this case was the first report about ERC1-RET fusion in a patient with PDAC. It is a pity that the patient refused targeted therapy for personal reasons. Our study has shed a new light on the companion diagnostics and targeted therapy for the patients with PDAC.