# GATA6 expression distinguishes classical and basal-like subtypes in advanced pancreatic cancer

Source: https://onco.cc/key-papers/paper-okane-gata6-basal-like-compass-ccr-2020/  
OnCo record `paper-okane-gata6-basal-like-compass-ccr-2020` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In 195 patients treated with chemotherapy for advanced pancreatic cancer, one in five had the basal-like type; those patients responded a third as often, progressed on FOLFIRINOX four times as often and lived 5.9 rather than 9.3 months, and a simple GATA6 tissue stain picked the type out.

## Summary

Within COMPASS, patients proceeding to chemotherapy for advanced pancreatic ductal adenocarcinoma had biopsies RNA-sequenced. Between December 2015 and May 2019, 195 patients (95%) had enough tissue; 39 (20%) were basal-like and 156 (80%) classical. Among 157 with response data, the overall response rate was 10% in basal-like against 33% in classical (P = 0.02); in basal-like tumours treated with modified FOLFIRINOX the progression rate was 60% against 15% (P = 0.0002). Median overall survival was 9.3 months for classical against 5.9 for basal-like (hazard ratio 0.47; P = 0.0001). GATA6 expression by RNA sequencing correlated with the classifier and in situ hybridisation predicted subtype with sensitivity 89% and specificity 83%; GATA6 was prognostic in multivariate analysis. Basal-like tumours could be identified by keratin 5, were more hypoxic and enriched for a T-cell-inflamed signature.

## Fields

- Kind: Key paper
- Last checked: 2026-09-24
- Journal: Clinical Cancer Research
- Year: 2020
- DOI: 10.1158/1078-0432.CCR-19-3724
- Authors: O'Kane GM, Grunwald BT, Jang GH, et al.
- Findings: Basal-like 20% of 195; response 10% versus 33%; FOLFIRINOX progression 60% versus 15%.; Median overall survival 5.9 versus 9.3 months (hazard ratio 0.47).; GATA6 in situ hybridisation: sensitivity 89%, specificity 83% for the classical subtype.
- What it means: It is the number behind 'basal-like is chemoresistant' and the validation of the GATA6 stain that lets a pathology laboratory call the subtype without RNA sequencing.
- Caveats: Single-programme cohort; treatment not randomised by subtype.; The T-cell-inflamed signal in basal-like tumours has not yet translated into immunotherapy benefit.

## Sources

- O'Kane et al., Clin Cancer Res 2020: GATA6 and the basal-like subtype in 195 COMPASS patients: https://doi.org/10.1158/1078-0432.CCR-19-3724
- PubMed: https://pubmed.ncbi.nlm.nih.gov/32156747/

## Connected records

- cancers: [Metastatic pancreatic ductal adenocarcinoma](https://onco.cc/cancers/metastatic-pdac/), [Pancreatic ductal adenocarcinoma](https://onco.cc/cancers/pancreatic/)
- technologies: [RNA sequencing & expression profiling](https://onco.cc/technologies/rna-seq/)
- drugs: [FOLFIRINOX / mFOLFIRINOX](https://onco.cc/drugs/folfirinox/)
- institutions: [Ontario Institute for Cancer Research](https://onco.cc/institutions/oicr/), [Princess Margaret Cancer Centre](https://onco.cc/institutions/princess-margaret/)
- pathways: [Epigenetic reprogramming](https://onco.cc/pathways/epigenetic-reprogramming/)
- terms: [COMPASS: real-time sequencing of advanced pancreatic cancer for treatment selection](https://onco.cc/terms/compass-study-pancreatic/), [GATA6 as the marker of classical versus basal-like pancreatic cancer](https://onco.cc/terms/gata6-classical-basal-marker/), [Immunohistochemistry (IHC)](https://onco.cc/terms/ihc/)
- journals: [Clinical Cancer Research](https://onco.cc/journals/clinical-cancer-research/)

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