The development of complete personalized treatment plans for colon cancer patients utilizing three gene prediction models.

Background

Combination chemotherapy using fluorouracil, leucovorin with or without oxaliplatin (5-FU and FOLFOX) are standard treatment for locally advanced colon cancer. However, about half of the patients developed recurrence. The objective of this study was to use gene profiling to predict treatment efficacy for colon cancer patients (stages 1-3). We developed three prediction models: the first determines the likelihood of recurrence after curative resection while the other two models determine the efficacy of 5-FU and FOLFOX.

Methods

Formalin-fixed paraffin-embedded tissues from 513 patients treated during 2003 to 2011 at Taipei Veterans General Hospital (80% of them are treated between 2005 to 2009) were analyzed for gene expression using Nugen Ovation kits and Affymetirix’s ST arrays. The gene data was analyzed using supervised clustering K-nearest-neighbor method. The performance of the models was evaluated using a Hazard Ratio (HR) for disease-free survival.

Results

In model one, for prediction of recurrence, the HR of non-recurrence vs. recurrence is 2.758 (P

Conclusions

A consistent three-model-prediction has been developed that provides valuable indictors for colon cancer treatment.