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New biomarkers for selecting anticancer drugs are needed to enhance the effectiveness of current multimodal treatment approaches. This study aimed to find a new biomarker by using clinical data and specimens collected for a Japanese randomized controlled trial (RCT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Gene expression array analysis was performed using PC tissues collected for the ancillary research of JASPAC01, a nationwide phase 3 RCT of adjuvant chemotherapy for patients with PC in Japan. A candidate gene was validated using tissue and blood samples from a second PC patient cohort undergoing radical surgery at the authors\u2019 institution. Additionally, experiments were performed with cancer cell lines to investigate the functions of the candidate gene.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Expression of\n                      <jats:italic>E2F7<\/jats:italic>\n                      mRNA was the most influential prognostic factor of postoperative overall survival outcomes in the primary tissue-available cases in the JASPAC01 cohort (hazard ratio [HR], 1.386; 95% confidence interval [CI], 1.005\u20131.912;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045). High\n                      <jats:italic>E2F7<\/jats:italic>\n                      expression itself correlates with poor survival outcomes (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045 for OS). Moreover, the benefits of adjuvant S-1 treatment were reduced in high\n                      <jats:italic>E2F7<\/jats:italic>\n                      cases (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.042 for OS;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007 for RFS).\n                      <jats:italic>In vitro<\/jats:italic>\n                      experiments demonstrated that\n                      <jats:italic>E2F7<\/jats:italic>\n                      inhibition suppressed cancer cell proliferation and minimized the 50% inhibitory concentration of S-1.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Tissue mRNA expression levels of\n                      <jats:italic>E2F7<\/jats:italic>\n                      correlated with patient prognosis in PC. In the low\n                      <jats:italic>E2F7<\/jats:italic>\n                      mRNA expression group, patients who received S-1 as adjuvant chemotherapy had a better prognosis than those who received gemcitabine (GEM).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1245\/s10434-025-18912-3","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T19:47:20Z","timestamp":1766778440000},"page":"5429-5440","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["High E2F7 Expression Indicates Pancreatic Cancer Aggressiveness and Downregulation of E2F7 Enhances Sensitivity to S-1"],"prefix":"10.1245","volume":"33","author":[{"given":"Keizo","family":"Fujita","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukiyasu","family":"Okamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masamichi","family":"Hayashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Ashida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohisa","family":"Otsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Sakai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinji","family":"Mii","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motokazu","family":"Sugimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoto","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirochika","family":"Toyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsuyuki","family":"Maeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobumasa","family":"Mizuno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukihiro","family":"Yokoyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junpei","family":"Yamaguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhiko","family":"Nakagawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keisuke","family":"Kurimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruyoshi","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideki","family":"Takami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Enomoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsuhiko","family":"Uesaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuro","family":"Kanda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,12,26]]},"reference":[{"key":"18912_CR1","first-page":"7","volume":"69","author":"RL Siegel","year":"2019","unstructured":"Siegel RL, Miller KD, Jemal A. 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