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Radiosensitivity Index for Outcomes in Pancreatic Cancer

Explore the use of a novel 10-gene biomarker to predict outcomes in resected pancreatic cancer patients who received adjuvant radiation. Results suggest radiosensitivity impacts survival rates.

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Radiosensitivity Index for Outcomes in Pancreatic Cancer

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  1. Discussant Slides: Title: Radiosensitivity Index Shows Promise for Predicting Outcomes with Adjuvant Radiation in Resected Pancreatic Cancer PatientsPoster #: Monitor 4Author: Ravi Shridhar MD, PhD

  2. Title: Index Shows Promise for Predicting Outcomes with Adjuvant Radiation in Resected Pancreatic Cancer PatientsPoster #: Monitor 4Author: Ravi Shridhar MD, PhD • Aims: • To compare intrinsic radiosensitivity of pancreatic cancers to other tumor types utilizing a novel 10 gene radiation specific biomarker that derives a radiosensitivity score (RSI) • To determine if RSI is prognostic for overall survival in resected pancreatic cancer

  3. Title: Radiosensitivity Index Shows Promise for Predicting Outcomes with Adjuvant Radiation in Resected Pancreatic Cancer PatientsPoster #: Monitor 4Author: Ravi Shridhar MD, PhD • Methods: • RSI score was calculated from a deidentified pool of 13261 genomically-profiled tumor specimens (Affymetrix Hu-RSTA-2a520709) from our Total Cancer Care Program (2006-2010) • RSI scores from 452 pancreatic cancer specimens were compared against the rest • From our tumor registry, we identified 251 resected pancreatic adenocarcinomas, of which 80 patients (49 who received postop CRT) had profiles from which we could derive RSI scores • From this dataset, a median RSI score was calculated and used a cutpointto determine prognosis

  4. Title: Radiosensitivity Index Shows Promise for Predicting Outcomes with Adjuvant Radiation in Resected Pancreatic Cancer PatientsPoster #: Monitor 4Author: Ravi Shridhar MD, PhD

  5. Title: Radiosensitivity Index Shows Promise for Predicting Outcomes with Adjuvant Radiation in Resected Pancreatic Cancer PatientsPoster #: Monitor 4Author: Ravi Shridhar MD, PhD • Results • Pancreatic cancer was more radioresistant than other cancers based on RSI P<0.0001 PDF – probability density function

  6. Title: Radiosensitivity Index Shows Promise for Predicting Outcomes with Adjuvant Radiation in Resected Pancreatic Cancer PatientsPoster #: Monitor 4Author: Ravi Shridhar MD, PhD • Results • We defined • High risk (HR) (R1, N1, and postop CA19-9>90) • Low risk (LR) (R0, N0, postop CA19-9<90) • RSI high = Radioresistant (RR) • RSI low = Radiosensitive (RS) • HR patient had worse OS (hazard ratio 4.4: 1.8-11.1; p=0.001) compared to LR. • In HR radiated pts, 3y OS for RS vs RS was 38% vs 8% (p=0.07). RSI was not prognostic in unirridiated pts (p=0.79). • Integrating RSI into risk stratification to define intermediate risk (IR) • No difference in OS between HR-RS vs LR-RR (3y OS 38% vs 50%; p=0.29). • RSI adds significant prognostic value to the risk stratification defined in this analysis (Figure 2, Table 1).

  7. Title: Radiosensitivity Index Shows Promise for Predicting Outcomes with Adjuvant Radiation in Resected Pancreatic Cancer PatientsPoster #: Monitor 4Author: Ravi Shridhar MD, PhD • Results

  8. Title: Radiosensitivity Index Shows Promise for Predicting Outcomes with Adjuvant Radiation in Resected Pancreatic Cancer PatientsPoster #: Monitor 4Author: Ravi Shridhar MD, PhD • Results P=0.001

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