TY - JOUR
T1 - Impact of classical and basal-like molecular subtypes on overall survival in resected pancreatic cancer in the SPACIOUS-2 multicentre study
AU - Suurmeijer, José Annelie
AU - Soer, Eline Christine
AU - Dings, Mark Pui Gien
AU - Kim, Yongsoo
AU - Strijker, Marin
AU - Bonsing, Bert Anne
AU - Brosens, Lodewijk Adriaan Anton
AU - Busch, Olivier Robert
AU - Groen, Jesse Vincent
AU - Halfwerk, Johannes Berend Gerardus
AU - Slooff, Robbert Alexander Eduard
AU - van Laarhoven, Hanneke Wilma Marlies
AU - Molenaar, Isaac Quintus
AU - Offerhaus, George Johan Arnold
AU - Morreau, Johannes
AU - van de Vijver, Marc Jone
AU - Fariña Sarasqueta, Arantza
AU - Verheij, Joanne
AU - Besselink, Marc Gerard
AU - Bijlsma, Maarten Fokke
AU - Dijk, Frederike
N1 - Funding Information:
This work was supported by a KWF Dutch Cancer Society grant to M.J.V., O.R.B., and H.W.L. (UVA 2014–6803), and by a Deltaplan Alvleesklierkanker grant to J.A.S. and M.G.B. The funders were not involved in the study design or drafting of the manuscript. J.A.S. and E.C.S. are joint first authors. M.G.B., M.F.B., and F.D. are shared senior authors. The authors would like to thank the patients for participating in the study.
Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved.
PY - 2022/11
Y1 - 2022/11
N2 - BACKGROUND: The recently identified classical and basal-like molecular subtypes of pancreatic cancer impact on overall survival (OS). However, the added value of routine subtyping in both clinical practice and randomized trials is still unclear, as most studies do not consider clinicopathological parameters. This study examined the clinical prognostic value of molecular subtyping in patients with resected pancreatic cancer.METHODS: Subtypes were determined on fresh-frozen resected pancreatic cancer samples from three Dutch centres using the Purity Independent Subtyping of Tumours classification. Patient, treatment, and histopathological variables were compared between subtypes. The prognostic value of subtyping in (simulated) pre- and postoperative settings was assessed using Kaplan-Meier and Cox regression analyses.RESULTS: Of 199 patients with resected pancreatic cancer, 164 (82.4 per cent) were classified as the classical and 35 (17.6 per cent) as the basal-like subtype. Patients with a basal-like subtype had worse OS (11 versus 16 months (HR 1.49, 95 per cent c.i. 1.03 to 2.15; P = 0.035)) than patients with a classical subtype. In multivariable Cox regression analysis, including only clinical variables, the basal-like subtype was a statistically significant predictor for poor OS (HR 1.61, 95 per cent c.i. 1.11 to 2.34; P = 0.013). When histopathological variables were added to this model, the prognostic value of subtyping decreased (HR 1.49, 95 per cent c.i. 1.01 to 2.19; P = 0.045).CONCLUSION: The basal-like subtype was associated with worse OS in patients with resected pancreatic cancer. Adding molecular classification to inform on tumor biology may be used in patient stratification.
AB - BACKGROUND: The recently identified classical and basal-like molecular subtypes of pancreatic cancer impact on overall survival (OS). However, the added value of routine subtyping in both clinical practice and randomized trials is still unclear, as most studies do not consider clinicopathological parameters. This study examined the clinical prognostic value of molecular subtyping in patients with resected pancreatic cancer.METHODS: Subtypes were determined on fresh-frozen resected pancreatic cancer samples from three Dutch centres using the Purity Independent Subtyping of Tumours classification. Patient, treatment, and histopathological variables were compared between subtypes. The prognostic value of subtyping in (simulated) pre- and postoperative settings was assessed using Kaplan-Meier and Cox regression analyses.RESULTS: Of 199 patients with resected pancreatic cancer, 164 (82.4 per cent) were classified as the classical and 35 (17.6 per cent) as the basal-like subtype. Patients with a basal-like subtype had worse OS (11 versus 16 months (HR 1.49, 95 per cent c.i. 1.03 to 2.15; P = 0.035)) than patients with a classical subtype. In multivariable Cox regression analysis, including only clinical variables, the basal-like subtype was a statistically significant predictor for poor OS (HR 1.61, 95 per cent c.i. 1.11 to 2.34; P = 0.013). When histopathological variables were added to this model, the prognostic value of subtyping decreased (HR 1.49, 95 per cent c.i. 1.01 to 2.19; P = 0.045).CONCLUSION: The basal-like subtype was associated with worse OS in patients with resected pancreatic cancer. Adding molecular classification to inform on tumor biology may be used in patient stratification.
UR - http://www.scopus.com/inward/record.url?scp=85140144138&partnerID=8YFLogxK
U2 - 10.1093/bjs/znac272
DO - 10.1093/bjs/znac272
M3 - Article
C2 - 35979597
SN - 0007-1323
VL - 109
SP - 1150
EP - 1155
JO - The British journal of surgery
JF - The British journal of surgery
IS - 11
ER -