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Can Gene Expression Profiling Identify Pancreatic Ductal Adenocarcinoma Patients with Short or Long-Term Prognosis?

Brandon Stone, Bryan J Thibodeau, Andrew M Baschnagel, Laura E Fortier, Zakiya Kelley, Amro Almradi, George D Wilson, Robert P Jury

Objectives The ability to identify patients that have disease progression soon after surgical resection could guide treatment as well as aid in the development of novel targeted therapies. This study correlates gene expression and overall survival in patients with pancreatic adenocarcinoma. Methods Patients with pancreatic adenocarcinoma treated with definitive surgery without neoadjuvant therapy were grouped into short-term (<10 months, n=13) and long-term (>20 months, n=11) survivors. Ribonucleic acid was extracted from snapfrozen tissues, and global gene expression was examined. Pathway analysis was also performed. Results The mean overall survival in each group was 7.5 and 32.0 months. We identified 163 genes that were differentially expressed between patients who survived <10 months and >20 months after definitive surgery. Many of the genes identified have known prognostic importance; however, less than half of these genes have been reported to be associated with survival in pancreatic adenocarcinoma. Pathway analysis identified expression targets of SP1, JUN, and EGF to be highly regulated based upon differences in overall survival. Conclusions In pancreatic adenocarcinoma patients who have undergone definitive resection, we have identified multiple genes associated with inferior survival. Many of the genes reported in this study have not previously been linked to overall survival in this patient population.