Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Oct 24, 2023; 14(10): 409-419
Published online Oct 24, 2023. doi: 10.5306/wjco.v14.i10.409
Classification of patients with metastatic colorectal cancer into consensus molecular subtypes into real-world: A pilot study
Jaime González-Montero, Mauricio Burotto, Guillermo Valenzuela, Debora Mateluna, Florencia Buen-Abad, Jessica Toro, Olga Barajas, Katherine Marcelain
Jaime González-Montero, Mauricio Burotto, Bradford Hill Clinical Research Center, Santiago 8420383, Chile
Jaime González-Montero, Guillermo Valenzuela, Debora Mateluna, Florencia Buen-Abad, Jessica Toro, Olga Barajas, Katherine Marcelain, Basic and Clinical Oncology Department, University of Chile, Santiago 8380453, Chile
Author contributions: González-Montero J led the study, wrote the manuscript, and created the figures and tables; González-Montero J, Burotto M, and Barajas O led the molecular classification of the patients; Valenzuela G, Toro J, and Marcelain K performed molecular biology procedures; Barajas O, Mateluna D, and Buen-Abad F recruited the patients.
Supported by Agencia Nacional de Investigación y Desarrollo de Chile, Fondo Nacional de Investigación en Salud (FONIS), No. SA20I0059.
Institutional review board statement: The study was reviewed and approved by the Medical Oncology Supervisor of Bradford Hill Clinical Research Center.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors declare have not conflict of interest to declare.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jaime González-Montero, MD, PhD, Assistant Professor, Basic and Clinical Oncology Deparment, University of Chile. Bradford Hill Clinical Research Center. Independencia 1027, Casilla 70058, Santiago 8380453, Chile. jagonzalez@ug.uchile.cl
Received: July 25, 2023
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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

The primary motivation is to progress towards a consensus molecular classification of metastatic colorectal cancer patients, to better guide targeted therapy.

Research objectives

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.

Research methods

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.

Research results

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.

Research conclusions

It is possible to classify patients with metastatic colorectal cancer into consensus molecular subtypes through RT-qPCR and NGS techniques.

Research perspectives

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.