{"entity":{"id":"paper-topham-subtype-discordant-pancreatic-ccr-2021","kind":"paper","name":"Subtype-discordant pancreatic ductal adenocarcinoma tumors show intermediate clinical and molecular characteristics","aka":[],"tldr":"Running six published subtype classifiers over 574 tumours, the authors found they agreed in 88% of cases, and the 12% they disagreed on were genuine hybrids with intermediate survival and intermediate KRAS allele imbalance.","summary":"Sequencing data for 574 pancreatic ductal adenocarcinomas from prospective trials and public databases were classified by six published strategies (Moffitt regression and clustering, Collisson, Bailey, Karasinska). Basal-like and classical calls were concordant in 88% and survival differed by subtype. Twelve percent of tumours were discordant and showed intermediate survival in univariate and multivariate analyses, hybrid expression profiles with classical and basal-like genes co-expressed, and intermediate mutant KRAS allelic imbalance (P < 0.001). Nearly 1 in 6 patients had tumours that failed to fall reliably into either subtype on the two regression tools aimed at clinical practice.","asOf":"2026-09-24","links":[{"label":"Topham et al., Clin Cancer Res 2021: subtype-discordant tumours in 574 cases","url":"https://doi.org/10.1158/1078-0432.CCR-20-2831"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/33051307/"}],"tags":[],"related":[],"cancers":["pancreatic"],"sections":[],"technologies":["rna-seq"],"targets":["kras"],"drugs":[],"companies":[],"institutions":["bc-cancer"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["clinical-cancer-research"],"dependsOn":[],"notes":[],"journal":"Clinical Cancer Research","year":2021,"doi":"10.1158/1078-0432.CCR-20-2831","pmid":"33051307","authors":"Topham JT, Karasinska JM, Lee MKC, et al.","paperType":"translational","findings":["88% concordance between classifiers; 12% discordant hybrids.","Hybrids show intermediate survival and intermediate KRAS allelic imbalance."],"whatItMeans":"A subtype report should carry a confidence, and a trial that dichotomises subtype will misplace about one patient in eight.","caveats":["Retrospective; mixed platforms.","No treatment assignment by subtype."],"changedPractice":false,"participants":574},"route":"/key-papers/paper-topham-subtype-discordant-pancreatic-ccr-2021/","neighbours":{"cancer":[{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"}],"technology":[{"id":"rna-seq","kind":"technology","name":"RNA sequencing & expression profiling","route":"/technologies/rna-seq/"}],"target":[{"id":"kras","kind":"target","name":"KRAS","route":"/targets/kras/"}],"institution":[{"id":"bc-cancer","kind":"institution","name":"BC Cancer","route":"/institutions/bc-cancer/"}],"journal":[{"id":"clinical-cancer-research","kind":"journal","name":"Clinical Cancer Research","route":"/journals/clinical-cancer-research/"}]}}