CDX2 prognostic value in stage II/III resected colon cancer is related to CMS classification
Menée à partir d'échantillons tumoraux congelés après prélèvement sur 469 patients atteints d'un cancer du côlon de stade II ou III, puis validée sur 90 échantillons tumoraux complémentaires, cette étude met en évidence l'association entre l'expression du facteur de transcription CDX2 et la survie chez un sous-groupe de patients défini par la classification internationale CMS
Background : Caudal-type homeobox transcription factor 2 (CDX2) is involved in colon cancer (CC) oncogenesis and has been proposed as a prognostic biomarker in patients with stage II or III CC.
Patients and methods : We analyzed CDX2 expression in a series of 469 CC typed for the new international consensus molecular subtype (CMS) classification, and we confirmed results in a series of 90 CC.
Results : Here, we show that lack of CDX2 expression is only present in the mesenchymal subgroup (CMS4) and in MSI-immune tumors (CMS1) and not in CMS2 and CMS3 colon cancer. Although CDX2 expression was a globally independent prognostic factor, loss of CDX2 expression is not associated with a worse prognosis in the CMS1 group, but is highly prognostic in CMS4 patients for both relapse free and overall survival. Similarly, lack of CDX2 expression was a bad prognostic factor in MSS patients, but not in MSI.
Conclusions : Our work suggests that combination of the consensual CMS classification and lack of CDX2 expression could be a useful marker to identify CMS4/CDX2-negative patients with a very poor prognosis.
Annals of Oncology , résumé, 2016