Tempus AI, a leader in applying AI to advance precision medicine, has announced the publication of a study in JCO Precision Oncology validating the clinical utility of its algorithmic diagnostic, PurIST. The study offers the largest real-world evidence to date supporting the integration of PurIST into routine care for patients with advanced Pancreatic Ductal Adenocarcinoma (PDAC), aiming to guide first-line chemotherapy selection and improve patient outcomes.
Pancreatic cancer is among the deadliest malignancies, with limited treatment options and a five-year survival rate of only 12%. For advanced, unresectable PDAC, the most common first-line regimens—FOLFIRINOX (FFX) and gemcitabine plus nab-paclitaxel (GnP)—show variable efficacy, and reliable biomarkers for therapy selection have been lacking. To address this, Tempus partnered with GeneCentric to develop PurIST, an RNA-based diagnostic that classifies PDAC tumors into “classical” or “basal” subtypes.
In the Tempus-led study, researchers analyzed data from 931 real-world PDAC patients using the Tempus xR RNA sequencing platform to assign PurIST subtypes. Patients received either FFX or GnP as first-line treatment, and clinical outcomes were assessed based on subtype. The findings demonstrate PurIST’s value as both a prognostic and predictive biomarker, allowing clinicians to tailor first-line therapy and improve survival prospects for advanced PDAC patients.
Prognostic Value: Among 536 patients treated with FFX, those with the classical subtype showed a median overall survival (OS) of 11.8 months versus 7.0 months for basal subtype patients (Hazard Ratio [HR]=1.86; p<0.001).
Predictive Value: In 311 classical subtype patients with good performance status (ECOG 0 or 1), FFX therapy led to a 33% reduction in death risk compared to GnP (HR=0.67; p<0.009). No similar benefit was seen in basal subtype patients.
"Pancreatic cancer is a challenging disease, and the ability to match patients to the most effective first-line therapy is critical. Prior research has suggested that certain molecular subtypes are associated with distinct prognoses and responses to therapy, but until now, large-scale real-world validation in a clinical setting has been lacking," said Ezra Cohen, MD, Chief Medical Officer, Oncology. "Our study demonstrates that PurIST subtyping enables a biomarker-driven approach to therapy selection, addressing a major unmet need in the management of pancreatic cancer." "PurIST is a step forward for pancreatic cancer molecular testing, giving healthcare providers a new tool to better inform personalized treatment options for this devastating disease," said Michael Milburn, PhD, President and CEO of GeneCentric and co-author on the publication. "GeneCentric’s collaboration with Tempus allowed us to validate the algorithm leveraging the power of Tempus’ multimodal data to rapidly deliver a much-needed test for patients with PDAC."