Clinical and Genomic Features of Classical and Basal Transcriptional Subtypes in Pancreatic Cancer

Harshabad Singh, Joanne Xiu, Kevin S. Kapner, Chen Yuan, Raja R. Narayan, Matthew Oberley, Alex Farrell, Rishi Surana, Brandon M. Huffman, Kimberly Perez, James M. Cleary, Alexander C. Jordan, Andressa Dias Costa, Hannah L. Williams, Srivatsan Raghavan, Benjamin Weinberg, Michael J. Pishvaian, Rachna T. Shroff, Sanjay Goel, Stephanie K. DouganJonathan A. Nowak, David Spetzler, George Sledge, Brian M. Wolpin, Andrew J. Aguirre

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Transcriptional profiling of pancreatic cancers has basal (SB). SC and SB tumors showed strong associations with defined two main transcriptional subtypes: classical and basal. histologic phenotypes and biopsy sites. SB tumors had higher rates Initial data suggest shorter survival for patients with basal tumors of KRAS, TP53, and ARID1A mutations, lower rates of SMAD4 and differing treatment sensitivity to FOLFIRINOX and gemci- mutation, and transcriptional evidence of epithelial-mesenchymal tabine plus nab-paclitaxel by transcriptional subtype. transition. Sixty of 77 cases (78%) maintained their transcriptional Experimental Design: We examined 8,743 patients with RNA subtype between temporally and/or spatially disparate lesions. In sequencing from pancreatic cancers performed at Caris Life Sciences. the outcome cohort, the SB subtype was associated with shorter Classical and basal subtypes were identified using purity independent overall survival time, regardless of whether they received FOL-subtyping algorithm on RNA sequencing, and two cohorts were FIRINOX or gemcitabine plus nab-paclitaxel as first-line chemo-analyzed: (i) the biomarker cohort included patients with complete therapy. The mutant KRAS allele type was prognostic of outcomes; molecular profiling data (n ¼ 7,250) and (ii) the outcome cohort however, this impact was restricted to SC tumors, whereas all included patients with metastatic disease with available survival out- mutant KRAS alleles had similarly poor outcomes in SB tumors. comes (n ¼ 5,335). A total of 3,842 patients were shared between the Conclusions: The SB subtype is a strong independent pretwo cohorts. Kaplan–Meier curves and Cox proportional hazards dictor of worse outcomes, regardless of the up-front chemo-regression were used to assess patient survival. therapy regimen used. Clinical trials should further investigate Results: In the biomarker cohort, 3,063 tumors (42.2%) were pancreatic cancer transcriptional subtypes as a prognostic and strongly classical (SC) and 2,015 tumors (27.8%) were strongly predictive biomarker.

Original languageEnglish (US)
Pages (from-to)4932-4942
Number of pages11
JournalClinical Cancer Research
Volume30
Issue number21
DOIs
StatePublished - Nov 1 2024

ASJC Scopus subject areas

  • General Medicine

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