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Colorectal Cancer Recurrence Risk Assessment Marker announced at the National Colorectal Surgery Symposium

December 16, 2020

The 15th (2020) National Colorectal Surgery New Technology Seminar and Hunan Provincial Medical Association Surgery Professional Committee Colorectal Surgery Group Annual Meeting” was held in Changsha from December 11th to 13th. The meeting was sponsored by the Colorectal Disease Expert Committee of the Chinese Medical Doctors Association and the Colorectal Surgery Group of the Hunan Medical Association.

Major developments in the field of colorectal cancer surgery, diagnosis and treatment, and basic research progress were shared during the conference. There were also video competitions of young doctors performing surgery. The diverse conference formats and rich cutting-edge content brought nearly 200 participants to the conference.

Professor Huang Zhongzheng, Chairman of the conference, Chairman of the Colorectal Disease Expert Committee of the Chinese Medical Doctor Association, and head of the Colorectal Surgery Group of the Hunan Medical Association, gave a keynote presentation on “Research Progress in Comprehensive Diagnosis and Treatment of Phase II Colorectal Cancer”. In his speech, he pointed out that the prognosis of patients with stage II colorectal cancer is highly variable, and that overall benefit of adjuvant chemotherapy is not more than 5%. Therefore, these patients need to be stratified according to the risk of recurrence after surgery to determine a more effective treatment plan.

Professor Huang listed the high-risk factors recommended by NCCN, CSCO and other guidelines, such as T4, poor tissue differentiation, and vascular/nerve infiltration, but these clinicopathological factors are difficult to objectively quantify. Other commonly used markers such as MSI-H/dMMR only stratifies 10% of the patient population, thus limiting its clinical benefit. Therefore, the NCCN guidelines believe that these existing “recurrence risk factors” are not enough to guide clinical decision-making, and it is still necessary to explore better recurrence risk assessment markers to select the population most likely to benefit from adjuvant chemotherapy.

Professor Huang next focused on the objective and quantitative recurrence risk assessment marker for colorectal cancer-Coloprog®. Coloprog® is a combined detection of DNA ploidy and tumor-to-interstitial ratio in tumor tissues of patients with colorectal cancer. With Coloprog®, the degree of malignancy of the tumor itself can be assessed more accurately, so as to assess the risk of recurrence after radical resection.

In a clinical study conducted by the University of Oxford, the powerful stratification capabilities of Coloprog® on the risk of recurrence of stage II colorectal cancer was verified (5-year cancer-specific survival rate: high-risk group vs. low-risk group, HR=2.9, 95% CI: 1.7-4.8, P<0.001). When compared with other clinicopathological high-risk recurrence factors, such as T4 staging, MSI status, and degree of tissue differentiation, and it was found that Coloprog® outperformed these biomarkers in recurrence risk assessment.

After Coloprog® was introduced into China by MBM, several clinical verification studies have been conducted, including a multi-center study led by Professor Cai Sanjun from the Cancer Hospital of Fudan University, and a study by Professor Wang Xishan from the Cancer Hospital of the Chinese Academy of Medical Sciences (research study under peer-review), and a study by Professor Wu Aiwen of Peking University Cancer Hospital (published in British Journal of Cancer). All these studies have further demonstrated the value of Coloprog® in the risk stratification of stage II colorectal cancer in Chinese patients.

In addition, through an analysis of the correlation between the benefits of Coloprog® and adjuvant therapy, it is found that Coloprog® has a significant predictive value for the effectiveness of adjuvant chemotherapy, in which high-risk patients showed the most benefit from adjuvant chemotherapy, while low-risk patients have no benefit. This data provides further evidence that Coloprog® can be used to guide auxiliary clinical treatment decision-making.

At the end of his presentation, Professor Huang first heard of the Coloprog® technology two years ago, and now the domestic clinical results have confirmed the benefits of Coloprog® in the Chinese population and is gradually being developed in clinical practice. Professor Huang also encourages his fellow colleagues to utilize to the results of Coloprog® in clinical practice, so as to benefit more patients with stage II colorectal cancer.

Coloprog®

Coloprog®’s digital pathology detection technology platform was developed by the Norwegian Institute for Cancer Genetic Information (ICGI), the world’s leading tumor genetic information and artificial intelligence digital pathology research institution, and was clinically verified by the University of Oxford. The research results were published in the Annals of Oncology in 2018.

Coloprog® was introduced to China by MBM, and a number of clinical studies have been carried out in China to validate Coloprog® in guiding postoperative adjuvant treatment decisions.

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