Cancer Family
Pancreaticobiliary Neoplasm
CI-CAN-00000309Explore in graph →
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- C223357
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Cancer Family
CI-CAN-00000309Explore in graph →
Variants & evidence
213 evidence items mapped to this entity or its descendants, grouped by molecular profile, then therapy. 50 items per page.
| Therapy | Cancer | Type | Level | Direction · significance | Rating (1–5) | Status | Evidence | Source |
|---|---|---|---|---|---|---|---|---|
| KRAS G12D3 | ||||||||
| Phosphatidylinositide 3-Kinase Inhibitor | Malignant Pancreatic Neoplasm | Predictive | D | Supports Sensitivity Response | 2 | submitted | EID7181In vivo genetic evidence for context-specific effector pathways of oncogenic Kras in PDAC and define cell autonomous Kras → PI3K → PDK1 signaling as a therapeutic target in pancreatic cancer. Targeti… (full text at CIViC) PMID 23453624 · Eser et al., 2013 · Open in CIViC | civic |
| Setidegrasib | Pancreatic Ductal Adenocarcinoma | Predictive | B | Supports Sensitivity Response | 3 | submitted | EID12938A phase 1 dose‑escalation and dose‑expansion study in patients with previously treated advanced KRAS p.G12D mutant pancreatic ductal adenocarcinoma (NCT05382559; n = 203 overall; n = 21 PDAC treated a… (full text at CIViC) PMID 41879829 · Park et al., 2026 · Open in CIViC | civic |
| Vemurafenib | Malignant Pancreatic Neoplasm | Predictive | D | Supports Resistance | — | submitted | EID3959In an in vitro study, PLX-4032 cell lines expressing KRAS G12D mutation demonstrated resistance to vemurafenib treatment, compared to PDA_014 cell expressing BRAF V600E mutation (a known sensitizing m… (full text at CIViC) PMID 25855536 · Witkiewicz et al., 2015 · Open in CIViC | civic |
| CDKN2A p16 R80* + KRAS G12DCDKN2AKRAS1 | ||||||||
| Afatinib + Palbociclib + TrametinibCombination | Malignant Pancreatic Neoplasm | Predictive | C | Supports Sensitivity Response | 3 | submitted | EID11713In this clinical trial, 18 patients with pancreatic cancer were recruited. In this case, the patient (63 y/F) with pancreatic cancer harboring CDKN2A_p16 R80* and KRAS G12D, was treated with Palbocicl… (full text at CIViC) PMID 36670111 · Shaya et al., 2023 · Open in CIViC | civic |
| ERBB2 E717D + KRAS G12DERBB2KRAS1 | ||||||||
| (oncogenic) | Pancreatic Ductal Adenocarcinoma | Oncogenic | D | Supports Oncogenicity | 3 | submitted | EID11556KRAS G12D-transformed HPNE cells with lentiviral vectors containing the variant significantly increased colony formation in number and size in soft agar compared to infected HPNE cells with the varian… (full text at CIViC) PMID 31046123 · Li et al., 2020 · Open in CIViC | civic |
| ERBB2 Q679L + KRAS G12DERBB2KRAS1 | ||||||||
| (oncogenic) | Pancreatic Ductal Adenocarcinoma | Oncogenic | D | Supports Oncogenicity | 3 | submitted | EID11554KRAS G12D-transformed HPNE cells with lentiviral vectors containing the variant significantly increased colony formation in number and size in soft agar compared to infected HPNE cells with the varian… (full text at CIViC) PMID 31046123 · Li et al., 2020 · Open in CIViC | civic |
| ERBB2 S310F + KRAS G12DERBB2KRAS1 | ||||||||
| (oncogenic) | Pancreatic Ductal Adenocarcinoma | Oncogenic | D | Supports Oncogenicity | 3 | submitted | EID11548KRAS G12D-transformed HPNE cells with lentiviral vectors containing the variant significantly increased colony formation in number and size in soft agar compared to infected HPNE cells with the varian… (full text at CIViC) PMID 31046123 · Li et al., 2020 · Open in CIViC | civic |
| ERBB2 S423R + KRAS G12DERBB2KRAS1 | ||||||||
| (oncogenic) | Pancreatic Ductal Adenocarcinoma | Oncogenic | D | Supports Oncogenicity | 3 | submitted | EID11550KRAS G12D-transformed HPNE cells with lentiviral vectors containing the variant significantly increased colony formation in number and size in soft agar compared to infected HPNE cells with the varian… (full text at CIViC) PMID 31046123 · Li et al., 2020 · Open in CIViC | civic |
| GNAS R201C + KRAS G12D + NF1 D1976fsGNASNF1KRAS1 | ||||||||
| Trametinib | Malignant Pancreatic Neoplasm | Predictive | C | Supports Sensitivity Response | 3 | submitted | EID11714In this clinical trial, 18 patients with pancreatic cancer were recruited. In this case, the patient (82 y/F) with pancreatic cancer harboring GNAS R201C, KRAS G12D and, NF1 D1976fs, was treated with … (full text at CIViC) PMID 36670111 · Shaya et al., 2023 · Open in CIViC | civic |
| CDKN2A Loss + CDKN2B Loss + KRAS G12D + KRAS G12R + SMAD4 Deletion + TP53 R267WKRASTP53CDKN2ACDKN2BSMAD41 | ||||||||
| Bevacizumab + Palbociclib + TrametinibCombination | Malignant Pancreatic Neoplasm | Predictive | C | Supports Sensitivity Response | 3 | submitted | EID11711In this clinical trial, 18 patients with pancreatic cancer were recruited. In this case, the patient (63 y/F) with pancreatic cancer harboring, CDKN2A exons 1-2 loss, CDKN2B loss, KRAS G12D, KRAS G12R… (full text at CIViC) PMID 36670111 · Shaya et al., 2023 · Open in CIViC | civic |
| CDKN2A Loss + CDKN2B Loss + KRAS G12D + KRAS G12R + TP53 R267WKRASTP53CDKN2ACDKN2B1 | ||||||||
| Bevacizumab + Palbociclib + TrametinibCombination | Malignant Pancreatic Neoplasm | Predictive | C | Supports Sensitivity Response | 3 | submitted | EID11710In this clinical trial, 18 patients with pancreatic cancer were recruited. In this case, the patient (69 y/M) with pancreatic cancer harboring, CDKN2A exons 1-2 loss, CDKN2B loss, KRAS G12D, KRAS G12R… (full text at CIViC) PMID 36670111 · Shaya et al., 2023 · Open in CIViC | civic |
| KRAS G12/G132 | ||||||||
| Gemcitabine + TrametinibCombination | Pancreatic Adenocarcinoma | Predictive | B | Supports Resistance | 4 | accepted | EID622Adding trametinib to gemcitabine does not improve overall survival (OS), progression-free survival (PFS), overall response rate (ORR) or duration of response (DOR) in patients with untreated metastati… (full text at CIViC) PMID 24915778 · Infante et al., 2014 · Open in CIViC | civic |
| Trametinib | Pancreatic Adenocarcinoma | Predictive | B | Does Not Support Sensitivity Response | 3 | accepted | EID990KRAS G12/G13 status was evaluated in cell-free DNA (cfDNA) of patients with untreated metastatic adenocarcinoma of the pancreas that were randomised (1:1) to receive gemcitabine plus trametinib or pla… (full text at CIViC) PMID 24915778 · Infante et al., 2014 · Open in CIViC | civic |
| KRAS G12R2 | ||||||||
| (prognostic) | Malignant Pancreatic Neoplasm | Prognostic | B | Supports Poor Outcome | 4 | accepted | EID1298In 242 patients with unresectable pancreatic cancer, the presence of KRAS G12R (N=17) or G12D (N=92) was associated with poorer prognosis (overall survival HR 1.6; 95% confidence interval 1.11-2.28). PMID 22983505 · Ogura et al., 2013 · Open in CIViC | civic |
| 〃 | Malignant Pancreatic Neoplasm | Prognostic | B | Supports Poor Outcome | 4 | rejected | EID1299In 242 patients with unresectable pancreatic cancer, the presence of KRAS G12R (as well as G12D) was associated with poorer prognosis (95% confidence interval of HR between 1.11 and 2.28). PMID 22983505 · Ogura et al., 2013 · Open in CIViC | civic |
| KRAS KRAS4A1 | ||||||||
| KG5 + RigosertibSubstitutes | Malignant Pancreatic Neoplasm | Predictive | D | Supports Resistance | 4 | rejected | EID9601An in vitro study shows that KRAS4A KO is significantly associated with reduced cell viability when cells are treated with KG5 (p < 0.0001). Moreover KRAS4A KO is significantly associated with reduced… (full text at CIViC) PMID 34257283 · Chen et al., 2021 · Open in CIViC | civic |
| KRAS KRAS4A underexpression1 | ||||||||
| RG5 + RigosertibSubstitutes | Malignant Pancreatic Neoplasm | Predictive | D | Supports Resistance | 4 | submitted | EID9602An in vitro study shows that KRAS4A KO is significantly associated with reduced cell viability when cells are treated with KG5 (p < 0.0001). Moreover KRAS4A KO is significantly associated with reduced… (full text at CIViC) PMID 34257283 · Chen et al., 2021 · Open in CIViC | civic |
| KRAS Mutation1 | ||||||||
| PI3Kbeta Inhibitor AZD8186 + SCH772984Combination | Pancreatic Adenocarcinoma | Predictive | D | Supports Sensitivity Response | 4 | accepted | EID1003Inhibition of ERK in 11 KRAS mutant pancreatic cancer cell lines with SCH772984 was more effective than MEK Inhibition. Combined Treatment with PI3K Inhibitor AZD8186 was more effective than either ag… (full text at CIViC) PMID 26725216 · Hayes et al., 2016 · Open in CIViC | civic |
| KRAS V14I1 | ||||||||
| (predisposing) | Malignant Pancreatic Neoplasm | Predisposing | D | N/A N/A | 2 | submitted | EID8041The authors demonstrated that in contrast to the K-RasG12D or K-RasG12V mouse models, mice that express the K-RasV14I mutation at postnatal stages, either in all cells or only in the lungs, did not de… (full text at CIViC) PMID 27174785 · Hernández-Porras et al., 2016 · Open in CIViC | civic |
| MAGEH1 EXPRESSION1 | ||||||||
| Gemcitabine | Bile Duct Adenocarcinoma | Predictive | D | Supports Resistance | 2 | accepted | EID95010 biliary tract carcinoma cell lines were sorted based on their gemcitabine sensitivity. MAGEH1 protein expression was negatively correlated with sensitivity. In a clinical validation cohort, MAGEH p… (full text at CIViC) PMID 20088962 · Ojima et al., 2010 · Open in CIViC | civic |
| MAP2K2 G132D1 | ||||||||
| Trametinib | Pancreatic Adenocarcinoma | Predictive | C | Supports Resistance | 2 | submitted | EID7732In this case report, a 66-year old woman with pancreatic ductal adenocarcinoma was treated with trametinib for a BRAF in-frame-deletion and TP53 mutation and achieved an initial partial response for c… (full text at CIViC) PMID 29903880 · Aguirre et al., 2018 · Open in CIViC | civic |
| MAP2K2 G132S1 | ||||||||
| Trametinib | Pancreatic Adenocarcinoma | Predictive | C | Supports Resistance | 2 | submitted | EID7733In this case report, a 66-year old woman with pancreatic ductal adenocarcinoma was treated with trametinib for a BRAF in-frame-deletion and TP53 mutation and achieved an initial partial response for c… (full text at CIViC) PMID 29903880 · Aguirre et al., 2018 · Open in CIViC | civic |
| MAP2K2 H123Q1 | ||||||||
| Trametinib | Malignant Pancreatic Neoplasm | Predictive | C | Supports Resistance | 2 | submitted | EID7731In this case report, a 66-year old woman with pancreatic ductal adenocarcinoma was treated with trametinib for a BRAF in-frame-deletion and TP53 mutation and achieved an initial partial response for c… (full text at CIViC) PMID 29903880 · Aguirre et al., 2018 · Open in CIViC | civic |
| MIR218-1 UNDEREXPRESSION1 | ||||||||
| (prognostic) | Malignant Pancreatic Neoplasm | Prognostic | D | Supports Poor Outcome | 3 | accepted | EID1184The study found mir-218 was significantly under-expressed when compared to matched adjacent normal tissue in 107 samples via qPCR. Further, low expression of mir-218 was revealed to be associated with… (full text at CIViC) PMID 26662432 · Li et al., 2015 · Open in CIViC | civic |
| NOTCH3 Overexpression1 | ||||||||
| Tarextumab | Malignant Pancreatic Neoplasm | Predictive | D | Supports Sensitivity Response | 3 | submitted | EID7001Notably, the antitumor efficacy of OMP-59R5 in combination with gemcitabine was significantly associated with expression of human Notch3 gene in pancreatic cancer. Tumors that were more sensitive to t… (full text at CIViC) PMID 25934888 · Yen et al., 2015 · Open in CIViC | civic |
| NQO1 Overexpression1 | ||||||||
| NSC84167 | Pancreatic Ductal Adenocarcinoma | Predictive | D | Supports Sensitivity Response | 2 | accepted | EID12560In preclinical pancreatic ductal adenocarcinoma (PDAC) models with high NQ01 expression, which indicates the NFE2L2 (NRF2) pathway activation, the small molecule NSC84167 (NSLC01, 50 mg/kg) selectivel… (full text at CIViC) PMID 34247201 · Dai et al., 2021 · Open in CIViC | civic |
| NR4A2 Overexpression1 | ||||||||
| C-DIM 12 + GemcitabineCombination | Pancreatic Ductal Adenocarcinoma | Predictive | D | Supports Resistance | 3 | submitted | EID12649In pancreatic cancer cell lines MiaPaCa2 and Panc1, gemcitabine 1 μmol/L induced NR4A2/NURR1 expression and triggered cytoprotective autophagy, while both CRISPR-mediated NR4A2 knockout and the NR4A2 … (full text at CIViC) PMID 35582016 · Zarei et al., 2021 · Open in CIViC | civic |
| ATG12 Overexpression + ATG7 Overexpression + NR4A2 OverexpressionNR4A2ATG7ATG121 | ||||||||
| (prognostic) | Pancreatic Ductal Adenocarcinoma | Prognostic | B | Supports Poor Outcome | 3 | submitted | EID12650In a retrospective TCGA PDAC (tumors n = 179, normals n = 171), high ATG7 expression was significantly associated with poorer survival on Kaplan–Meier analysis (P = 0.013), and high ATG12 expression s… (full text at CIViC) PMID 35582016 · Zarei et al., 2021 · Open in CIViC | civic |
| NRG1 NRG1 FUSIONS1 | ||||||||
| Afatinib | Malignant Pancreatic Neoplasm | Predictive | C | Supports Sensitivity Response | 3 | rejected | EID7467Two patients with pancreatic adenocarcinoma harboring NRG1 gene fusions were treated with afatinib. Both of them showed a tumor response. PMID 31068372 · Jones et al., 2019 · Open in CIViC | civic |
| PALB2 Biallelic Inactivation1 | ||||||||
| Mitomycin | Malignant Pancreatic Neoplasm | Predictive | C | Supports Sensitivity Response | 4 | accepted | EID1305In a patient with gemcitabine-refractory pancreatic cancer, a tumor-derived xenograft was found to be responsive to Mitomycin C. After disease progression, the patient was started on a regimen of mito… (full text at CIViC) PMID 21135251 · Villarroel et al., 2011 · Open in CIViC | civic |
| PALB2 Mutation2 | ||||||||
| Rucaparib | Malignant Pancreatic Neoplasm | Predictive | B | Supports Sensitivity Response | 2 | submitted | EID9294For this single-arm phase II trial patients with locally advanced or metastatic pancreatic cancer (neuroendocrine excluded); and had a confirmed pathogenic or likely pathogenic germline (g) or somatic… (full text at CIViC) PMID 33970687 · Reiss et al., 2021 · Open in CIViC | civic |
| Talazoparib | Pancreatic Ductal Adenocarcinoma | Predictive | C | Supports Sensitivity Response | 3 | submitted | EID10835A patient with pancreatic ductal adenocarcinoma (PDAC) and a somatic PALB2 mutation (NM_024675.4: c.3350+1G>T) experienced disease progression after 10 cycles of FOFIRINOX and 2 cycles of gemcitabine.… (full text at CIViC) PMID 36119518 · Kachmazov et al., 2022 · Open in CIViC | civic |
| POLD1 Loss2 | ||||||||
| ATR Inhibitor | Malignant Pancreatic Neoplasm | Predictive | D | Supports Sensitivity Response | 4 | submitted | EID13257siRNA-mediated POLA1 protein depletion sensitized PaTu8988t pancreatic cancer cells to the ATR inhibitors ceralasertib (AZD6738) and berzosertib (VE-822), producing approximately 7-fold and 6-fold IC5… (full text at CIViC) PMID 39128273 · Schneider et al., 2024 · Open in CIViC | civic |
| Chk1 Inhibitor | Malignant Pancreatic Neoplasm | Predictive | D | Supports Sensitivity Response | 4 | submitted | EID13258siRNA-mediated POLA1 protein depletion sensitized PaTu8988t pancreatic cancer cells to the CHK1 inhibitors LY2603618 and MK-8776, producing approximately 7-fold and 13-fold IC50 shifts, respectively, … (full text at CIViC) PMID 39128273 · Schneider et al., 2024 · Open in CIViC | civic |
| PTEN Loss1 | ||||||||
| Akt Inhibitor MK2206 | Pancreatic Carcinoma | Predictive | C | Supports Sensitivity Response | 2 | accepted | EID938Among 33 patients treated with pan-AKT inhibitor MK-2206 in this phase 1 study, one patient with pancreatic adenocarcinoma and PTEN loss/KRAS G12D mutation experienced a decrease of approximately 60% … (full text at CIViC) PMID 22025163 · Yap et al., 2011 · Open in CIViC | civic |
| RABL3 MUTATION1 | ||||||||
| (predisposing) | Malignant Pancreatic Neoplasm | Predisposing | C | Supports Pathogenic | 3 | submitted | EID7497Whole-genome sequence analysis in a family with multiple cases of pancreatic ductal adenocarcinoma identified a germline RABL3 truncating mutation. RABL3 was associated with the regulation of the pren… (full text at CIViC) PMID 31406347 · Nissim et al., 2019 · Open in CIViC | civic |
| RB1 Overexpression1 | ||||||||
| Doxorubicin + Fluorouracil + Gemcitabine + MitomycinSubstitutes | Pancreatic Adenocarcinoma | Predictive | D | Supports Resistance | 2 | accepted | EID1324In Capan-1 cell lines engineered to reduce pRB expression (by transfection with p16), resensitization to chemotherapy-induced apoptosis was observed. The effect was asserted to be specific to pRB depl… (full text at CIViC) PMID 11792751 · Plath et al., 2002 · Open in CIViC | civic |
| RRM1 Overexpression1 | ||||||||
| Gemcitabine | Malignant Pancreatic Neoplasm | Predictive | D | Supports Resistance | 2 | accepted | EID1859The mRNA expression level of RRM1 was analyzed by RT-PCR in 3 human pancreatic cancer cell lines cultured in incrementally increased concentrations of gemcitabine. Expression levels of RRM1 progressiv… (full text at CIViC) PMID 17224927 · Nakano et al., 2007 · Open in CIViC | civic |
| RRM1 Underexpression2 | ||||||||
| Gemcitabine | Malignant Pancreatic Neoplasm | Predictive | B | Supports Sensitivity Response | 3 | accepted | EID5506There were 68 patients enrolled in this study, 28 of which were treated with gemcitabine. Of those 28, 14 patients had a low RRM1 expression and 14 had a high RRM1 expression. Only the patients with … (full text at CIViC) PMID 19543324 · Akita et al., 2009 · Open in CIViC | civic |
| 〃 | Malignant Pancreatic Neoplasm | Predictive | B | Supports Sensitivity Response | 3 | accepted | EID5508In this study, human pancreatic carcinoma cell line MiaPaCa2, which is a gemcitabine-sensitive cell line, was used for the establishment of chemoresistant cells MiaPaCa2-RG. Analysis for identifying g… (full text at CIViC) PMID 17131328 · Nakahira et al., 2007 · Open in CIViC | civic |
| RRM2 OVEREXPRESSION1 | ||||||||
| Gemcitabine | Malignant Pancreatic Neoplasm | Predictive | D | Supports Resistance | 2 | accepted | EID1860The mRNA expression level of RRM2 was analyzed by RT-PCR in 3 human pancreatic cancer cell lines cultured in incrementally increased concentrations of gemcitabine. Expression levels of RRM2 progressi… (full text at CIViC) PMID 17224927 · Nakano et al., 2007 · Open in CIViC | civic |
| SIRT1 Overexpression1 | ||||||||
| Niacinamide | Malignant Pancreatic Neoplasm | Predictive | D | Supports Resistance | 1 | accepted | EID1294In-vitro study with MiaPaCa-2 and PANC-1 pancreatic cancer cell lines. Inhibition of Sirt1 by increasing concentrations of nicotinamide led to a decrease in viability. Gefitinib treatment with concent… (full text at CIViC) PMID 24088390 · Stenzinger et al., 2013 · Open in CIViC | civic |
| SLC29A1 Overexpression1 | ||||||||
| Gemcitabine | Pancreatic Adenocarcinoma | Predictive | B | Supports Sensitivity Response | 4 | accepted | EID10145Surgically resected PDACs were used to create tissue microarrays, which were scored for antibody staining of hENT1 (SLC29A1). For patients treated with gemcitabine (n=243), high levels of hENT1 were a… (full text at CIViC) PMID 22705007 · Maréchal et al., 2012 · Open in CIViC | civic |
| ROS1 Fusion1 | ||||||||
| Crizotinib | Pancreatic Adenocarcinoma | Predictive | C | Supports Sensitivity Response | 3 | submitted | EID11651In this case report of a single patient with pancreatic adenocarcinoma was found to harbour a SLC4A4::ROS1 fusion by NGS analysis. Based on the presence of the ROS1 fusion the patient was initiated on… (full text at CIViC) PMID 37079858 · Reutter et al., 2023 · Open in CIViC | civic |
| SMAD4 Expression2 | ||||||||
| (prognostic) | Pancreatic Ductal Adenocarcinoma | Prognostic | B | Supports Better Outcome | 3 | accepted | EID1306In 249 patients that have undergone a pancreaticoduodenectomy (Whipple) for the resection of pancreatic ductal adenocarcinoma, expression of SMAD4 is associated with favorable prognosis. SMAD4 was ass… (full text at CIViC) PMID 11751510 · Tascilar et al., 2001 · Open in CIViC | civic |
| 〃 | Malignant Pancreatic Neoplasm | Prognostic | C | Supports N/A | 3 | submitted | EID7179One of the goals in this study was to examine the correlation between Smad4 expression, detected by immunostaining, and the pattern of disease progression in pancreatic adenocarcinoma. Eleven of 15 (7… (full text at CIViC) PMID 21709185 · Crane et al., 2011 · Open in CIViC | civic |
| SMAD4 LOSS1 | ||||||||
| (prognostic) | Malignant Pancreatic Neoplasm | Prognostic | B | Supports Poor Outcome | 3 | accepted | EID1412Study employed a rapid autopsy technique on a cohort of 76 patients with pancreatic cancer and explored the status of several genes. 63% (41/65) of carcinomas analyzed showed inactivation of SMAD4 (DP… (full text at CIViC) PMID 19273710 · Iacobuzio-Donahue et al., 2009 · Open in CIViC | civic |
| SMAD4 Mutation1 | ||||||||
| (prognostic) | Pancreatic Adenocarcinoma | Prognostic | B | Supports Poor Outcome | 3 | accepted | EID511In a study of 89 patients with adenocarcinoma of the pancreas who underwent a pancreaticoduodenectomy, those with mutations in SMAD4 had shorter overall survival than wild-type patients. PMID 19584151 · Blackford et al., 2009 · Open in CIViC | civic |
| SMAD4 Underexpression2 | ||||||||
| (prognostic) | Malignant Pancreatic Neoplasm | Prognostic | B | Supports Better Outcome | 4 | submitted | EID6440In patients with Pancreatic Cancer, about half of them show an under expression of SMAD4. There was no relationship between SMAD4 expression and OS, but PFS was much longer in patients with SMAD4 unde… (full text at CIViC) PMID 28534865 · Ormanns et al., 2017 · Open in CIViC | civic |
| 〃 | Malignant Pancreatic Neoplasm | Prognostic | B | Supports Poor Outcome | 4 | submitted | EID6445Using univariate analysis, the results showed that underexpression of SMAD4 had a strong relationship with poor OS in pancreatic cancer patients. More specifically, the underexpression of SMAD4 was re… (full text at CIViC) PMID 26947875 · Shugang et al., 2016 · Open in CIViC | civic |
Data updated 30 minutes agoSource updated unknownsource: civic (CC0)
Evidence levels, directions and ratings are those assigned by CIViC curators. "Submitted" items have not completed curation review. This is not treatment guidance.