CDX2 prognostic value in stage II/III resected colon cancer is related to CMS classification.
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.


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.
Personalized Medicine, Pharmacogenomics, Therapeutic Optimization, INSERM UMR-S1147, Université Paris Descartes, Paris.
C
C
Pilati
Department of Hepatogastroenterology and Gastrointestinal Oncology, Georges Pompidou Hospital, Assistance Publique-Hopitaux de Paris, Université Paris Descartes, Paris.
J
J
Taieb
Personalized Medicine, Pharmacogenomics, Therapeutic Optimization, INSERM UMR-S1147, Université Paris Descartes, Paris.
R
R
Balogoun
Programme Cartes d'Identité des Tumeurs (CIT), Ligue Nationale Contre Le Cancer, Paris, France.
L
L
Marisa
Programme Cartes d'Identité des Tumeurs (CIT), Ligue Nationale Contre Le Cancer, Paris, France.
A
A
de Reyniès
Personalized Medicine, Pharmacogenomics, Therapeutic Optimization, INSERM UMR-S1147, Université Paris Descartes, Paris.
P
P
Laurent-Puig
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics*; D000071616:CDX2 Transcription Factor / Q000235:genetics*; D003110:Colonic Neoplasms / Q000145:classification / Q000235:genetics* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008297:Male; D053842:Microsatellite Instability; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000235:genetics* / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis
D014408:Biomarkers, Tumor; D000071616:CDX2 Transcription Factor; C491270:CDX2 protein, human
CDX2; colon cancer; consensus molecular subtype classification (CMS)