Translational Research Laboratory and Department of Medical Oncology, Institut Catala d'Oncologia-IDIBELL, Hospitalet de Llobregat, Spain
Ramon Salazar , Jaume Capdevila , Robert Rosenberg , Jan Willem de Waard , Bengt Glimelius , Frederic Bibeau , Joost Klaase , Jacobus JM Van der Hoeven , Rachel A Midgley , George J. Chang , Thomas Bachleitner-Hofmann , Michio Asano , Reinhard Ziebermayr , Edward Allen Levine , Kenneth B. Deck , Jamie Sington , Wai Lun Law , Imad Shbeeb , Lisette Stork , John Marshall
Background: The 18-gene expression profile, ColoPrint, has been developed and validated for identifying risk of recurrence in patients with early-stage colon cancer (CC). In a pooled stage II validation study ColoPrint identified 63% of patients as Low Risk with a 3-yr recurrence-free survival (RFS) of 93% while High Risk patients had a 3-yr RFS of 82% with a HR of 2.7 (p=0.001). PARSC is a prospective study for the assessment of recurrence risk in stage II CC patients using ColoPrint. ColoPrint classification is compared to NCCN risk classification. Methods: The study enrolled 468 patients with histologically proven stage II CC from 31 institutes in Europe, the United States, and Asia between October 2008 and May 2013. Synchronous tumors were excluded. ColoPrint results were not disclosed to the physician and patient. Treatment was at the discretion of the physician, adhering to NCCN approved regimens or a recognized alternative. A McNemars test is performed to compare ColoPrint with NCCN risk classification. A p value ≤ 0.05 indicates the two tests differ significantly. Results: ColoPrint classified 320 (68%) patients as Low Risk and 148 (32%) as High Risk. 89 patients (19%) received adjuvant chemotherapy. In the ColoPrint Low Risk group, 57 (18%) patients received adjuvant chemotherapy while 32 (22%) of ColoPrint High Risk patients received chemotherapy. According to NCCN high risk factors (T4, high grade (exclusive of MSI-H), lymphovascular/perineural invasion, perforation/obstruction, <12 nodes examined, positive margins) 234 (50%) patients were NCCN Low Risk and 234 were NCCN High Risk. 72 (31%) of the NCCN Low Risk patients are ColoPrint High Risk. 158 (68%) of the NCCN High Risk patients are ColoPrint Low Risk. MSI-status was assessed in 86 (18%) patients of which 29 were MSI high and 57 were MSS. All MSI high were classified as ColoPrint Low Risk. Conclusions: The PARSC study is the first prospective study to compare genomic and clinical risk assessment and we observed marked differences between NCCN risk classification and ColoPrint. The clinical validity of these methods will be based on the outcomes at 3 and 5 years. Clinical trial information: NCT00903565.
ColoPrint Low Risk | ColoPrint High Risk | Total | |
---|---|---|---|
NCCN Low Risk | 162 | 72 | 234 |
NCCN High Risk | 158 | 76 | 234 |
Total | 320 | 148 | p < 0.0001 |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2022 ASCO Annual Meeting
First Author: Yoanna S Pumpalova
2012 ASCO Annual Meeting
First Author: Ramon Salazar
2024 ASCO Annual Meeting
First Author: Ingrid A. Franken
2011 Gastrointestinal Cancers Symposium
First Author: Ramon Salazar