A new gene-based test for patients, called ColoPrint, could be used to help doctors predict the chance that colorectal cancer will come back after treatment (called a recurrence). The patients in this study had stage II colorectal cancer that was localized, meaning it had not spread far from where the cancer began. Surgery alone is an effective treatment for most patients with this type and stage of cancer. However, in about 20% of patients the cancer comes back, and these patients may benefit from chemotherapy after surgery to lower their risk of recurrence.
Knowing a patient's risk of recurrence could help doctors plan treatments, making sure that patients with a high risk of recurrence receive the appropriate treatment and helping patients with a low risk avoid side effects of additional treatments. To help predict the risk of recurrence, doctors use clinical factors, such as the stage, the number of lymph nodes that have cancer, and whether the cancer is blocking or has broken through the bowel. However, these cannot always reliably predict a patient's prognosis (chance of recovery).
In this study, researchers used the ColoPrint test to study the tumor tissue from 135 patients with stage II colon cancer who had surgery to remove the tumor. This test looked at 18 genes in the tumor to identify whether a patient had a high or low risk of the cancer recurring. For patients with stage II cancer, the test predicted that 73% had a low risk of recurrence and 27% had a high risk of recurrence. Of the patients with a low risk of recurrence, 5% had a recurrence within 5 years and 20% of the patients with a high risk of recurrence had the cancer come back within 5 years, showing that the test was able to predict a patient's risk of recurrence.
What this means for patients
“We are extremely encouraged by what these results may mean for people with colorectal cancer,” said lead author and surgeon Robert Rosenberg, MD, Assistant Professor at University Hospital of the Technical University in Munich, Germany. “While several gene-based tests that help predict the risk of recurrence have been developed, ColoPrint is the first test for patients with colorectal cancer. Tests based on the genes in a tumor are already used to improve breast cancer treatment, and we are well on our way to develop a similar model to guide treatment of stage II colorectal cancer.” Research on ColoPrint is still ongoing and is only available through clinical trials.
What to ask your doctor
- What stage of colorectal cancer do I have? What does this mean?
- What are my treatment options?
- What clinical trials are open to me?
- What is the chance that the cancer will come back after treatment?
- Are there ways to help reduce the risk of recurrence?
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