High γ-H2AX Predicts Clinical Benefit From Platinum-Based Chemotherapy (mFOLFIRINOX) at Recurrence After Pancreatic...

Postoperative regimen selection between mFOLFIRINOX and GnP for recurrent pancreatic ductal adenocarcinoma (PDAC) lacks evidence, highlighting the need for a simple biomarker. This study explores the impact of γ-H2AX overexpression, a DNA damage marker, in resected PDAC for predicting platinum-based treatment response in recurrences.

In this study, we assessed γ-H2AX and ABCB1 expressions in resected PDAC tissues from 198 patients to evaluate their impact on prognosis after surgery and response to chemotherapy in 109 recurrent cases.

High γ-H2AX expression was linked to shorter recurrence-free survival and overall survival (OS) compared to low expression (p = 0.024 and 0.0013). It was an independent poor prognostic factor post-surgery. In recurrent cases with high γ-H2AX expression, mFOLFIRINOX significantly improved OS compared to GnP (p = 0.013), while low γ-H2AX cases showed no significant OS difference between regimens (p = 0.576).

γ-H2AX overexpression in PDAC tissue is an independent negative prognostic factor. In recurrent cases, high γ-H2AX expression suggests better OS and treatment response with mFOLFIRINOX, indicating its potential as a chemosensitivity marker for personalized therapy in PDAC recurrence.