Peer-Reviewed Publication
J Clin Oncol2026;JCO2600327.July 27, 2026Journal Article
Developing a Histology-Based Artificial Intelligence Biomarker to Predict Adjuvant Chemotherapy Benefit in Pancreatic Cancer.
Audrey Beaufils1,2, Julien De Martino3, Xiaofeng Jiang2, Théau Blanchard1, Nicolas Fraunhoffer4,5,6, Diana Mendes1,3, Camille Pignolet1, Taib Bourega1, Asier Rabasco Meneghetti2, Srividhya Sainath2, Miguel Albuquerque3, Nathalie Colnot3, Matthieu Tihy1,3, Anthony Turpin7,8, Meher Ben Abdelghani9, Alice Wei10, Emmanuel Mitry11, Thierry Lecomte12,13, James Biagi14, Pascal Artru15, Ludovic Evesque16, Aurélien Lambert17, Daniel J Renouf18, Marjorie Mauduit19, Nelson J Dusetti4, Pascal Hammel20, Thierry Conroy17, Jean-Baptiste Bachet21, Louis de Mestier22, Vinciane Rebours22, Jérôme Cros1,3, Jakob Nikolas Kather2,23,24, Rémy Nicolle1
1Centre de Recherche sur l'Inflammation (CRI), Université Paris Cité, INSERM, U1149, CNRS, ERL 8252, Paris, France.
2Else Kroener Fresenius Center for Digital Health, Medical Faculty Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany.
3Department of Pathology-FHU MOSAIC, Beaujon Hospital, Université Paris Cité, INSERM UMR1149, Clichy, France.
4Cancer Research Center of Marseille (CRCM), INSERM, CNRS, Institute Paoli-Calmettes, Aix-Marseille University, Marseille, France.
5Programa franco-argentino de estudio del Cáncer de Páncreas, Buenos Aires, Argentina.
6Faculty of Medicine, Center for Pharmacological and Botanical Studies, Buenos Aires University, National Council for Scientific and Technical Research, Buenos Aires, Argentina.
7Medical Oncology Department, University Hospital, Lille, France.
8University of Lille, Lille, France.
9Medical Oncology Department, ICANS, Strasbourg, France.
10Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
11Medical Oncology Department, Institute Paoli-Calmettes, Marseille, France.
12François Rabelais University, Tours, France.
13Department of Hepatogastroenterology and Digestive Oncology, University Hospital of Tours, Tours, France.
14Department of Oncology, Queen's University, Kingston, ON, Canada.
15Hepatogastroenterology Department, Hospital Jean-Mermoz, Lyon, France.
16Department of Medical Oncology, Lacassagne Center, Nice, France.
17Medical Oncology Department, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France.
18Department of Medical Oncology, BC Cancer, Vancouver, BC, Canada.
19Unicancer, R&D, Paris, France.
20Digestive and Medical Oncology Department, Hospital Paul Brousse and University Paris-Saclay, Villejuif, France.
21Department of Gastroenterology, Pitié-Salpêtrière Hospital-Sorbonne Université, Paris, France.
22Department of Pancreatology and Digestive Oncology, APHP Nord, FHU MOSAIC, Beaujon Hospital, Clichy, France.
23Department of Medicine I, University Hospital Dresden, Dresden, Germany.
24Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany.
Abstract
PURPOSE: The choice of adjuvant chemotherapy in pancreatic ductal adenocarcinoma (PDAC) is mainly guided by patients' general condition. We hypothesized that tumor morphology may predict differential treatment benefit and tested whether deep learning applied to histology images could derive a biomarker of relative benefit from gemcitabine (GEM) versus modified FOLFIRINOX (mFOLFIRINOX) in resected…
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