Discussant Slides: Title: Radiosensitivity Index Shows Promise for Predicting Outcomes with Adjuvant Radiation in Resected Pancreatic Cancer Patients Poster.

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

Title: Index Shows Promise for Predicting Outcomes with Adjuvant Radiation in Resected Pancreatic Cancer Patients Poster #: Monitor 4 Author: Ravi Shridhar MD, PhD Aims: 1.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) 2.To determine if RSI is prognostic for overall survival in resected pancreatic cancer

Title: Radiosensitivity Index Shows Promise for Predicting Outcomes with Adjuvant Radiation in Resected Pancreatic Cancer Patients Poster #: Monitor 4 Author: Ravi Shridhar MD, PhD Methods: – RSI score was calculated from a deidentified pool of genomically-profiled tumor specimens (Affymetrix Hu-RSTA- 2a520709) from our Total Cancer Care Program ( ) – 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 cutpoint to determine prognosis

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

Results – Pancreatic cancer was more radioresistant than other cancers based on RSI P< PDF – probability density function

Title: Radiosensitivity Index Shows Promise for Predicting Outcomes with Adjuvant Radiation in Resected Pancreatic Cancer Patients Poster #: Monitor 4 Author: 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: ; 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).

Title: Radiosensitivity Index Shows Promise for Predicting Outcomes with Adjuvant Radiation in Resected Pancreatic Cancer Patients Poster #: Monitor 4 Author: Ravi Shridhar MD, PhD Results Population Median Survival (y)3-yr Survival (%)p-value All Patients High RSI Low RSI3.150 RT Patients (N=49) High RSI Low RSI2.729 No RT Patients (N=31) High RSI Low RSI3.155 RSI integrated into risk stratification Population Median Survival (y)3-yr Survival (%)p-value All Patients Low-riskNot reached Intermediate-risk2.639 High-risk1.321 RT Patients (N=49) Low-riskNot reached Intermediate-risk2.442 High-risk1.28 No RT Patients (N=31)Low-riskNot reached Intermediate-risk2.733 High-risk2.338

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