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This document is a letter published in the British Journal of Surgery. The authors comment on a recent study that investigated the use of baseline carbohydrate antigen 19-9 (CA19-9) as a predictive biomarker for patients undergoing neoadjuvant therapy for pancreatic ductal adenocarcinoma (PDAC). The authors highlight the importance of predictive biomarkers in guiding personalized treatment for PDAC and discuss the findings of the study. They argue that the study's results suggest that baseline CA19-9 can be a predictive factor for the treatment effect of neoadjuvant therapy on overall survival in PDAC patients. The authors suggest that further analysis should be conducted to explore the use of neoadjuvant systemic chemotherapy in patients with high CA19-9 levels. They commend the study and encourage the incorporation of CA19-9 as a biomarker in future clinical trials. [Extracted from the article]