Evidence map›Paper›PMID 41671529›Full record

ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2026

Development and Validation of a Computational Histology Artificial Intelligence-Powered Predictive Biomarker for Selection of Chemotherapy in Advanced Pancreatic Cancer.

Andrew E Hendifar, Viswesh Krishna, Vrishab Krishna, Haochen Zhang, Asit Tarsode, Vivek Nimgaonkar, Katelyn Smith, Kawther Abdilleh, Snehal Sonawane, Akshay Neema and 26 more

Abstract readValidation StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

36 authors.

Andrew E HendifarCedars Sinai Medical Center, Los Angeles, CA.ORCID 0000-0002-2079-9177
Viswesh KrishnaValar Labs, Inc, Palo Alto, CA.
Vrishab KrishnaValar Labs, Inc, Palo Alto, CA.
Haochen ZhangValar Labs, Inc, Palo Alto, CA.ORCID 0000-0002-8292-9491
Asit TarsodeValar Labs, Inc, Palo Alto, CA.ORCID 0009-0000-9560-3872
Vivek NimgaonkarValar Labs, Inc, Palo Alto, CA.
Katelyn SmithDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA.
Kawther AbdillehPancreatic Cancer Action Network, El Segundo, CA.ORCID 0009-0001-5316-9366
Snehal SonawaneValar Labs, Inc, Palo Alto, CA.
Akshay NeemaValar Labs, Inc, Palo Alto, CA.ORCID 0009-0002-5045-7298
Ekin TiuValar Labs, Inc, Palo Alto, CA.ORCID 0000-0002-9887-9724
Brent K LarsonCedars Sinai Medical Center, Los Angeles, CA.
Vladimir KazarovCedars Sinai Medical Center, Los Angeles, CA.
Natalie MoshayediCedars Sinai Medical Center, Los Angeles, CA.
Shawn HutchinsonWallace McCain Centre for Pancreatic Cancer, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.ORCID 0000-0002-2435-7114
Daniela BevacquaWallace McCain Centre for Pancreatic Cancer, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Sudheer DossPancreatic Cancer Action Network, El Segundo, CA.
Alejandra AlvarezPancreatic Cancer Action Network, El Segundo, CA.
Drew WatsonValar Labs, Inc, Palo Alto, CA.
Waleed M AbuzeidValar Labs, Inc, Palo Alto, CA.ORCID 0000-0003-2489-0514
Barbara T GrünwaldWallace McCain Centre for Pancreatic Cancer, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.ORCID 0000-0002-7541-5206
Marcus NoelRuesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.
Rashmi SamdaniRuesch Center for the Cure of Gastrointestinal Cancers, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC.ORCID 0000-0003-4909-7838
Dove KeithBrenden-Colson Center for Pancreatic Care, Oregon Health and Science University, Portland, OR.
Rosalie C SearsBrenden-Colson Center for Pancreatic Care, Oregon Health and Science University, Portland, OR.ORCID 0000-0003-1558-2413
Davendra SohalDepartment of Hematology & Oncology, University of Cincinnati Cancer Center, Cincinnati, OH.ORCID 0000-0002-0182-8403
Christos FountzilasRoswell Park Comprehensive Cancer Center, Buffalo, NY.ORCID 0000-0003-3837-5644
Grainne M O'KaneDepartment of Medical Oncology, St Vincent's University Hospital, School of Medicine, University College, Dublin, Ireland.ORCID 0000-0002-8690-403X
Robert C GrantWallace McCain Centre for Pancreatic Cancer, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.ORCID 0000-0002-9821-0377
Arsen OsipovCedars Sinai Medical Center, Los Angeles, CA.ORCID 0000-0002-9000-7040
Eric A CollissonFred Hutchinson Cancer Center, Seattle, WA.ORCID 0000-0002-2829-355X
Lesli A KiedrowskiValar Labs, Inc, Palo Alto, CA.ORCID 0000-0001-5081-2005
Trevor J RoyceValar Labs, Inc, Palo Alto, CA.ORCID 0000-0001-9879-1290
Anirudh R JoshiValar Labs, Inc, Palo Alto, CA.
Aatur D SinghiDepartment of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA.ORCID 0000-0003-3930-7096
Jennifer J KnoxWallace McCain Centre for Pancreatic Cancer, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.ORCID 0000-0003-3474-6647

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePredictive 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) versus gemcitabine-based (G-chemo) regimens.

methodsThe CHAI platform extracted quantitative histomorphologic features from whole-slide images of hematoxylin and eosin-stained diagnostic biopsies. In a multi-institutional development cohort, features associated with differential outcomes as measured by time to next treatment or death (TNTD) between F-chemo-treated and G-chemo-treated patients produced continuous biomarker scores, which were dichotomized into G-pref or F-pref results. The biomarker and threshold were locked. An independent validation cohort from the prospective COMPASS and Know Your Tumor studies assessed differential treatment outcomes by TNTD and overall survival (OS).

resultsThere were 477 patients (development: 178; validation: 299). In validation, among 173 F-pref patients, those treated with F-chemo had significantly better outcomes than G-chemo for both TNTD (

conclusionThe histomorphology-based GvF biomarker predicted differential treatment benefit of first-line GvF. This biomarker can guide optimal treatment selection for first-line therapy in advanced PDAC.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsArtificial IntelligenceBiomarkers, TumorCarcinoma, Pancreatic DuctalPancreatic NeoplasmsAgedDeoxycytidineFemaleFluorouracilGemcitabineHumansMaleMiddle AgedBiomarkers, TumorDeoxycytidineFluorouracilGemcitabine

Identifiers

PMID41671529
PMCPMC13557474

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.