Alderdice, Matthew, Richman, Susan D, Gollins, Simon, Stewart, Peter, Hurt, Christopher  ORCID: https://orcid.org/0000-0003-1206-8355, Adams, Richard  ORCID: https://orcid.org/0000-0003-3915-7243, McCorry, Amy, Roddy, Aideen, Vimalachandran, Dale, Isella, Claudio, Medico, Enzo, Maughan, Tim, McArt, Darragh G, Lawler, Mark and Dunne, Philip D
      2018.
      
      Prospective patient stratification into robust cancer-cell intrinsic subtypes from colorectal cancer biopsies.
      The Journal of Pathology
      245
      
        (1)
      
      , pp. 19-28.
      
      10.1002/path.5051
    
  
  
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Abstract
Colorectal cancer (CRC) biopsies underpin accurate diagnosis, but are also relevant for patient stratification in molecularly-guided clinical trials. The consensus molecular subtypes (CMS) and colorectal cancer intrinsic subtypes (CRIS) transcriptional signatures have potential clinical utility for improving prognostic/predictive patient assignment. However, their ability to provide robust classification, particularly in pre-treatment biopsies from multiple regions or at different time points remains untested. In this study, we undertook a comprehensive assessment of the robustness of CRC transcriptional signatures, including CRIS and CMS, using a range of tumour sampling methodologies currently employed in clinical and translational research. These include analyses using (i) laser-capture microdissected CRC tissue, (ii) eight publically available rectal cancer biopsy data sets (n=543), (iii) serial biopsies (from AXEBeam trial, NCT00828672; n=10), (iv) multi-regional biopsies from colon tumours (n=29 biopsies, n=7 tumours) and (v) pre-treatment biopsies from the phase II rectal cancer trial COPERNCIUS (NCT01263171; n=44). Compared to previous results obtained using CRC resection material, we demonstrate that CMS classification in biopsy tissue is significantly less capable of reliably classifying patient subtype (43% unknown in biopsy versus 13% unknown in resections, p=0.0001). In contrast, there was no significant difference in classification rate between biopsies and resections when using the CRIS classifier. Additionally, we demonstrated that CRIS provides significantly better spatially- and temporally- robust classification of molecular subtypes in CRC primary tumour tissue compared to CMS (p= 0.003 and p=0.02, respectively). These findings have potential to inform ongoing biopsy-based patient stratification in CRC, enabling robust and stable assignment of patients into clinically-informative arms of prospective multi-arm, multi-stage clinical trials.
| Item Type: | Article | 
|---|---|
| Date Type: | Publication | 
| Status: | Published | 
| Schools: | Research Institutes & Centres > Centre for Trials Research (CNTRR) Schools > Medicine  | 
      
| Publisher: | Wiley | 
| ISSN: | 0022-3417 | 
| Funders: | CRUK | 
| Date of First Compliant Deposit: | 12 February 2018 | 
| Date of Acceptance: | 1 February 2018 | 
| Last Modified: | 15 Nov 2024 16:45 | 
| URI: | https://orca.cardiff.ac.uk/id/eprint/109024 | 
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