Peer-Reviewed Publication
J Clin Oncol2026;JCO2502199.February 11, 2026Journal Article
Development and Validation of a Computational Histology Artificial Intelligence-Powered Predictive Biomarker for Selection of Chemotherapy in Advanced Pancreatic Cancer.
Andrew E Hendifar1, Viswesh Krishna2, Vrishab Krishna2, Haochen Zhang2, Asit Tarsode2, Vivek Nimgaonkar2,3, Katelyn Smith4, Kawther Abdilleh5, Snehal Sonawane2,6, Akshay Neema2, Ekin Tiu2, Brent K Larson1, Vladimir Kazarov1, Natalie Moshayedi1, Shawn Hutchinson7, Daniela Bevacqua7, Sudheer Doss5, Alejandra Alvarez5, Drew Watson2, Waleed M Abuzeid2, Barbara T Grünwald7,8,9, Marcus Noel10, Rashmi Samdani10, Dove Keith11, Rosalie C Sears11, Davendra Sohal12, Christos Fountzilas13, Grainne M O'Kane14, Robert C Grant7, Arsen Osipov1, Eric A Collisson15, Lesli A Kiedrowski2, Trevor J Royce2,16, Anirudh R Joshi2, Aatur D Singhi4, Jennifer J Knox7
1Cedars Sinai Medical Center, Los Angeles, CA.
2Valar Labs, Inc, Palo Alto, CA.
3Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, MD.
4Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA.
5Pancreatic Cancer Action Network, El Segundo, CA.
6University of Illinois at Chicago, Chicago, IL.
7Wallace McCain Centre for Pancreatic Cancer, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
8Department of Urology, University Hospital Essen, Essen, Germany.
9West German Cancer Center, Essen, Germany.
10Ruesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.
11Brenden-Colson Center for Pancreatic Care, Oregon Health and Science University, Portland, OR.
12Department of Hematology & Oncology, University of Cincinnati Cancer Center, Cincinnati, OH.
13Roswell Park Comprehensive Cancer Center, Buffalo, NY.
14Department of Medical Oncology, St Vincent's University Hospital, School of Medicine, University College, Dublin, Ireland.
15Fred Hutchinson Cancer Center, Seattle, WA.
16Department of Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, NC.
Abstract
PURPOSE: Predictive biomarkers to guide selection of first-line chemotherapy for advanced pancreatic ductal adenocarcinoma (PDAC) are an unmet clinical need. This study used the Computational Histology Artificial Intelligence (CHAI) platform to develop and validate a histomorphology-based G-chemo versus F-chemo (GvF) biomarker that predicts benefit from first-line fluoropyrimidine-based (F-chemo)…
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