An online gene expression assay for determining adjuvant therapy eligibility in patients with stage 2 or 3 colon cancer.
Bottom Line: the decision whether to treat patients with non-metastatic colon cancer with adjuvant chemotherapy is determined by clinical staging, frequently resulting in over or undertreatment. gene expression data and clinical information from 232 stage 1-4 colon cancer patients were analysed to identify expression patterns predictive of recurrence.The signature was evaluated on an independent series of 60 stage 2 and 3 patients.Multivariate analysis showed the classifier to be associated with approximately three- to fourfold increased risk of recurrence. the prognostic gene expression signature is able to stratify stage 2 and 3 colon cancer patients into groups with significant differences in 5-year DFS, information that may ultimately reduce deaths from colon cancer.
Affiliation: ChipDX LLC, PO Box 286874, New York, NY 10128, USA. email@example.comShow MeSH
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Mentions: In order to reflect the intended use of the assay, risk-group predictions for the subset of the training series with stage 2 or 3 colon cancer (n=144) were compared using Kaplan–Meier analysis for DFS and DSS. These predictions were generated using LOOCV, as part of the gene selection and algorithm training process, in order to minimise over fitting of the data (Simon, 2005). Log rank testing revealed a significant difference between the high- and low-risk groups for both DFS (P=0.0008, HR: 4.08 95% CI: 1.99–8.34) and DSS (P<0.0001, HR 19.59 95% CI: 8.33–46.07), and also for stratification by risk group and clinical staging (Figure 3). For comparison purposes, Kaplan–Meier analysis of these patients stratified by staging was performed, however the result was not statistically significant for either DFS (P=0.75) or DSS (P=0.30).
Affiliation: ChipDX LLC, PO Box 286874, New York, NY 10128, USA. firstname.lastname@example.org