Tumour sidedness and intrinsic subtypes in patients with stage II/III colon cancer: analysis of NSABP C-07 (NRG Oncology)

Br J Cancer. 2018 Mar 6;118(5):629-633. doi: 10.1038/bjc.2017.448. Epub 2017 Dec 14.

Abstract

Background: We tested the association of colon tumour sidedness with prognosis and with molecular subtypes recently shown to be predictive of oxaliplatin benefit in stage III colon cancer.

Methods: NSABP/NRG C-07 trial (N=1603) was used to determine association of tumour sidedness with molecular subtypes and recurrence-free survival (RFS) and overall survival (OS).

Results: Sidedness was associated with molecular subtypes except stem-like/CMS4 subtype. Patients with stage III, left-sided tumours showed superior OS but not RFS. Sidedness was not associated with prediction of oxaliplatin benefit when combined with 5-Fu+LV. However, greater benefit from oxaliplatin was observed in a small subset of stage III patients with left-sided, enterocyte-subtype tumours (interaction HR=0.17, P=0.01).

Conclusions: Sidedness was associated with molecular subtypes and was predictive of OS in stage III colon cancer but was not predictive of RFS or oxaliplatin benefit in C-07. Molecular subtypes may provide more predictive value for oxaliplatin benefit than tumour sidedness.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers, Tumor / metabolism
  • Colonic Neoplasms / drug therapy*
  • Colonic Neoplasms / metabolism
  • Colonic Neoplasms / pathology*
  • Disease-Free Survival
  • Female
  • Fluorouracil / therapeutic use*
  • Humans
  • Leucovorin / therapeutic use*
  • Male
  • Neoplasm Staging
  • Oxaliplatin / therapeutic use*
  • Prognosis
  • Survival Analysis
  • Treatment Outcome

Substances

  • Biomarkers, Tumor
  • Oxaliplatin
  • Leucovorin
  • Fluorouracil