A gene expression signature for predicting response to neoadjuvant chemoradiotherapy in pancreatic ductal adenocarcinoma

In patients with pancreatic ductal adenocarcinoma (PDAC), optimal treatment selection, including multimodality regimens such as neoadjuvant chemoradiotherapy (NACRT), can be clinically transformative. Unfortunately, currently no predictive biomarkers are available that can guide the use of NACRT in PDAC patients. Accordingly, herein we developed a novel gene signature that can preoperatively predict NACRT‐sensitivity in PDAC patients. Herein, we evaluated the performance of a 10‐gene panel in 749 PDAC cases, which included two public datasets (The Cancer Genome Atlas and International Cancer Genome Consortium; n = 276), and three clinical specimen cohorts (n = 417), and a pre‐NACRT endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) biopsy cohort (n = 56). The potential predictive performance of this signature was evaluated and compared to CA‐19‐9 levels and key clinicopathological factors. We first evaluated the prognostic potential of a 10‐gene panel which significantly predicted overall survival in both public datasets (P