Published online Oct 24, 2023. doi: 10.5306/wjco.v14.i10.409
Peer-review started: July 25, 2023
First decision: September 13, 2023
Revised: September 24, 2023
Accepted: October 8, 2023
Article in press: October 8, 2023
Published online: October 24, 2023
Processing time: 89 Days and 17 Hours
Colorectal cancer is a heterogeneous disease; therefore, it is crucial to progress towards a molecular consensus classification in order to predict prognosis and therapy response.
The primary motivation is to progress towards a consensus molecular classification of metastatic colorectal cancer patients, to better guide targeted therapy.
The aim of this study is to classify a sample of metastatic colorectal cancer patients into consensus molecular subtypes using a reverse transcription -quantitative polymerase chain reaction polymerase chain reaction (RT-qPCR) and next-generation genomic sequencing (NGS) protocol.
Patients with unresectable metastatic colorectal cancer who were undergoing systemic treatment with chemotherapy and/or targeted therapy. Molecular biology techniques were employed to analyse primary tumour samples from these patients. RT-qPCR was utilized to assess the expression of genes associated with fibrosis (TGF-β and β-catenin) and cell growth pathways. NGS using a 25-gene panel (TumorSec) was performed to identify specific genomic mutations. The patients were then classified into one of the four CMS categories according to the clinical consensus of a Tumour Board.
n = 26 metastatic colorectal cancer patients analyzed. 23% (n = 6), 19% (n = 5), 31% (n = 8), and 19% (n = 5) were classified as CMS1, CMS2, CMS3, and CMS4, respectively. Additionally, 8% of patients (n = 2) could not be classified into any of the four CMS categories.
It is possible to classify patients with metastatic colorectal cancer into consensus molecular subtypes through RT-qPCR and NGS techniques.
Prospective studies are needed to determine if this classification is useful and if it has an impact on predicting the survival of patients with metastatic colorectal cancer.