Colorectal Neoplasms Clinical Trial
Official title:
The Predictive Value of Guangzhou Panel for Recurrence in Early-stage Colorectal Cancer
This study aims to evaluate the predictive value of a four-gene methylation assay called Guangzhou Panel in early-stage colorectal cancer. Patients will be divided into two groups: high risk group and low risk group. The primary endpoint is 5 year disease free survival (DFS).
The current risk stratification system defined by clinicopathological features does not
identify the risk of disease recurrence in patients with early-stage colorectal cancer (CRC)
with optimal accuracy. The investigators aimed to investigate whether the epigenetic
alterations could serve as novel prognostic biomarkers that would improve the accuracy of the
current primary tumor, regional nodes, metastasis (TNM) staging system.
In the current study, the Investigators have analyzed the genome-wide methylation status of
cytosine-phosphate-guanosine (CpG) sites using Infinium MethylationEPIC array in primary
tumor and adjacent normal samples from 23 recurrent and 22 recurrence-free stage I and II CRC
patients to identify potential methylation markers for disease-free survival (DFS). The
prognostic value of the candidate biomarkers has been evaluated in a training cohort (n=174)
and an independent validation cohort (n=267), and is to be validated in a prospective cohort
(estimated n=287).
Comprehensive data analysis identified a subset of methylated CpG loci that associated with a
high risk of recurrence. Methylated CpGs in four genes were significantly associated with DFS
in multivariate analysis in both training and validation cohort. Moreover, Hypermethylated
Genes Counts panel using these four markers showed a higher prognostic value than any
clinicopathological factor, current molecular biomarkers or single methylated CpG marker
alone in the training and validation cohorts. This four-gene methylation assay is defined as
Guangzhou Panel.
The investigators aim to conduct a prospective observational study to evaluate the predictive
value of Guangzhou Panel in early-stage colorectal cancer. A total of 287 patients with
pathologically verified stage I-II CRC and underwent surgical resection are expected to be
recruited in our study. These patients will be divided into high-risk group and low-risk
group and will be followed up at least 5 years. The primary endpoint is 5-year disease free
survival (DFS). The prognostic strength of candidate biomarkers was adjusted in multivariate
Cox regression models including multiple biomarkers and clinicopathologic variables.
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