S189
Clinical - Biomarkers of clinical response
ESTRO 2026
the presence of distant metastases at initial staging. Material/Methods: We conducted a retrospective study between January 2019 and December 2023 including 50 patients with histologically confirmed pancreatic adenocarcinoma who underwent baseline 18F-FDG PET/CT prior to any treatment. Only patients with a visible primary pancreatic lesion were included. PET/CT was performed after at least 6 hours of fasting and approximately 60 minutes after intravenous injection of 18F-FDG. Low-dose CT was used for attenuation correction and anatomical localization. The SUVmax of the primary lesion was recorded from the PET/CT reports. Patients were classified according to metastatic status (M0 vs M1) at baseline. Results: Among 50 included patients, 40 (80%) had metastatic disease and 10 (20%) were non-metastatic at diagnosis. In the metastatic group, the SUVmax of the primary tumor ranged from 3.36 to 10.0, with a mean value of 5.39. In the non-metastatic group, SUVmax ranged from 2.46 to 5.24, with a mean of 3.52. The mean SUVmax was higher in patients with metastases compared to those without, suggesting an association between higher metabolic activity of the primary lesion and metastatic spread. Conclusion: In this retrospective series, a higher SUVmax of the primary pancreatic lesion on baseline 18F-FDG PET/CT was associated with the presence of distant metastases. These preliminary findings suggest that tumor metabolic activity may reflect biological aggressiveness and could serve as an early imaging biomarker for metastatic potential in pancreatic adenocarcinoma. Keywords: PET CT , pancreas , SUVmax Digital Poster 2679 A robust biomarker combining Radiomic and CA19.9 information to predict Distant Relapse-free Survival after Radiochemotherapy in Pancreatic Cancer Marco Fois 1 , Monica M Vincenzi 1 , Roberta Tummineri 2 , Martina Mori 1 , Laura Giannini 2 , Emiliano Spezi 3 , Maria Picchio 4 , Antonella del Vecchio 1 , Arturo Chiti 4,5 , Michele Reni 6,5 , Paolo Passoni 2 , Claudio Fiorino 1 , Nadia G Di Muzio 2,5 1 Medical Physics, IRCCS San Raffaele Scientific Institute, Milano, Italy. 2 Radiotherapy, IRCCS San Raffaele Scientific Institute, Milano, Italy. 3 School of Engineering, Cardiff University, Cardiff, United Kingdom. 4 Nuclear Medicine, IRCCS San Raffaele Scientific Institute, Milano, Italy. 5 Medicine, Vita-Salute University, Milano, Italy. 6 Oncology, IRCCS San Raffaele Scientific Institute, Milano, Italy
according to clinical outcome.BP analysis: Nine proteins showed significant differential abundance between early- and late-BP pts. Seven (PRDX2, PCSK9, HBE1, CPN1, CA1, ACTA2, SAA1) were more abundant in late-BP pts. Validation confirmed reduced plasma levels of CA1 and SAA1 in early-BP pts.DP analysis: Eight proteins discriminated polymetastatic- DP from no-DP pts, with KRT5, ACTA1, PON3 more abundant and CA1, KRT7, CPN1, PRG2 less abundant in polymetastatic cases. Conclusion: This extended follow-up confirms the feasibility and prognostic value of plasma proteomic profiling in orHSPC pts undergoing SBRT. Low CA1 and CPN1 levels appear associated with unfavorable outcomes, supporting their potential role as non-invasive prognostic markers.Future efforts will focus on multicenter validation using targeted immunoassays. References: 1. Lee H et al.Circulatory prostate cancer proteome landscapes and prognostic biomarkers in metastatic castrate resistant prostate cancer. Clin Proteomics 2025; 22(1):13.2. Al-Daffaie FM et al. Metabolomics and Proteomics in Prostate Cancer Research: Overview, Analytical Techniques, Data Analysis, and Recent Clinical Applications. Int J Mol Sci 2024; 25(10):5071.3. Repetto O et al. Prognostic role of plasma proteomics signature in oligorecurrent prostate cancer patients undergoing SBRT: results from a prospective trial. ESTRO 2025 Poster Discussion. Keywords: oligometastatic, prostate, proteomics, biomarkers Digital Poster 2498 SUVmax of Primary Pancreatic Tumors as a Marker of Metastatic Potential (A Study of 50 Cases) Ouassafrar Zakaria, Bensmimou Hafsa, Youssef Mustapha, Gbadamassi Abdelamid, Batani Halima, Guensi Amal Nuclear medecine, CHU Ibn Rochd, Casablanca, Morocco Purpose/Objective: Pancreatic cancer remains one of the most lethal cancers. Its poor prognosis is mainly due to late diagnosis. Identifying simple and reliable biomarkers is therefore crucial to better characterize tumor behavior and guide management. Among potential candidates, metabolic parameters derived from 18F- FDG PET/CT, particularly the maximum standardized uptake value (SUVmax), have gained increasing attention as potential indicators of tumor aggressiveness and metastatic potential.The aim of this work is To assess the relationship between baseline SUVmax of the primary pancreatic lesion and
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