Gene Expression Profiling Predicts Recurrence in Stage II/III Colon Cancer

According to a study presented at the 2006 annual meeting of the American Society of Clinical Oncology (ASCO), information about gene expression in colon tumors predicts the risk of cancer recurrence in patients with stage II or stage III colon cancer.

Gene expression profiling explores the patterns of genes that are active in tumor cells. Studies suggest that gene expression may provide information about prognosis or likely response to treatment in several types of cancer.

An example of a gene expression test is Oncotype DX, which is indicated for patients with newly diagnosed stage I or II, node-negative, estrogen-receptor positive breast cancer who will be treated with tamoxifen. The test evaluates a panel of 21 genes to predict a patient’s ten-year risk of cancer recurrence. Results from the Oncotype DX test have also been shown to predict response to chemotherapy.

The current study was a collaboration between the National Surgical Adjuvant Breast and Bowel Project (NSABP) and Genomic Health, the company that developed Oncotype DX.

To explore gene expression in relation to recurrence risk in patients with colon cancer, researchers evaluated tumor tissue from a total of 270 patients (128 with stage II cancer and 142 with stage III cancer).

The study assessed expression of 757 different genes, 78 of which were found to be significantly linked with cancer recurrence. Information about the expression of these genes in tumor tissue may allow for separation of stage II and stage III colon cancer patients into low-, intermediate-, and high-risk groups.

The researchers concluded that the laboratory technique used in this study can be used to identify genes associated with recurrence risk in patients with stage II or stage III colon cancer. If these results are confirmed, this technique has the potential to improve selection of patients for adjuvant chemotherapy.

Reference: O’Connell MJ, Paik S, Yothers G et al. Relationship Between Tumor Gene Expression and Recurrence in Stage II/III Colon Cancer: Quantitative RT-PCR Assay of 757 Genes in Fixed Paraffin-Embedded (FPE) Tissue. Presented at the 2006 ASCO Annual Meeting. Abstract 3518.

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