HRDsig was predictive of 1L FOLFIRNOX chemotherapy benefit with doubled OS relative to gemcitabine and paclitaxel (GP) (rwOS aHR 0.37 [0.22-0.62]), including 25% of the population with long-term (2 year+) survival in a real-world cohort of patients….A scar-based HRD biomarker was identified in a significant fraction of PC patients and is predictive of FOLFIRINOX benefit.

HRDsig(+) was observed in 9% (94/1081) of PC pts. 52% received FX and 48% GP in the 1L setting. Overall median rwOS for FX and GP was 6.9 and 5.1 mo. FX treated pts with HRDsig(+) had better rwOS and TTNT compared to those with HRDsig(-) (median rwOS 14.8 vs 6.3 mo; aHR: 0.50 (0.34 – 0.73), p <0.001; median TTNT 8.5 vs 5.3 mo; aHR: 0.54 (0.39 – 0.76), p < 0.001). rwOS at 1- and 2-years was 58% and 25% in FX-treated HRDsig(+) pts, relative to 21% and 2% in GP-treated HRDsig(+) pts....Using a real-world clinical dataset, we found that HRD sig positivity was predictive of FX benefit in metastatic PC.