Cited by 35Colorectal Cancer Treatments and StudiesColorectal Cancer Surgical TreatmentsGenetic factors in colorectal cancer

Consensus molecular subtype 4 (CMS4)-targeted therapy in primary colon cancer: a proof-of-concept study

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Peters, Niek A., Constantinides, Alexander, Ubink, Inge, van Kuik, Joyce, Bloemendal, Haiko J., van Dodewaard, Joyce M., Brink, Menno A., Schwartz, Thijs P. +10 more·2022·Frontiers in Oncology

Abstract

Background: Mesenchymal Consensus Molecular Subtype 4 (CMS4) colon cancer is associated with poor prognosis and therapy resistance. In this proof-of-concept study, we assessed whether a rationally chosen drug could mitigate the distinguishing molecular features of primary CMS4 colon cancer. Methods: In the ImPACCT trial, informed consent was obtained for molecular subtyping at initial diagnosis of colon cancer using a validated RT-qPCR CMS4-test on three biopsies per tumor (Phase-1, n=69 patients), and for neoadjuvant CMS4-targeting therapy with imatinib (Phase-2, n=5). Pre- and post-treatment tumor biopsies were analyzed by RNA-sequencing and immunohistochemistry. Imatinib-induced gene expression changes were associated with molecular subtypes and survival in an independent cohort of 3232 primary colon cancer. Results: The CMS4-test classified 52/172 biopsies as CMS4 (30%). Five patients consented to imatinib treatment prior to surgery, yielding 15 pre- and 15 post-treatment samples for molecular analysis. Imatinib treatment caused significant suppression of mesenchymal genes and upregulation of genes encoding epithelial junctions. The gene expression changes induced by imatinib were associated with improved survival and a shift from CMS4 to CMS2. Conclusion: Imatinib may have value as a CMS-switching drug in primary colon cancer and induces a gene expression program that is associated with improved survival.

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Authors
Peters, N. A., Constantinides, A., Ubink, I., van Kuik, J., Bloemendal, H. J., van Dodewaard, J. M., Brink, M. A., Schwartz, T. P., Lolkema, M. P. J. K., Lacle, M. M., Moons, L. M., Geesing, J., van Grevenstein, W. M. U., Roodhart, J. M. L., Koopman, M., Elias, S. G., Borel Rinkes, I. H. M., & Kranenburg, O.
Affiliations
  • Utrecht University (NL)
  • Radboud University Medical Center (NL)
  • Meander Medisch Centrum (NL)
  • Erasmus MC (NL)
  • Diakonessenhuis hospital (NL)
Corresponding author
Kranenburg, Onno
Venue
Frontiers in Oncology
Published
2022-09-06
Volume
12
Pages
969855-969855
ISSN
2234-943X (ISSN-L)
OpenAlex
W4294739303
Cited by
35
References
54
Citations by year
2026: 10 · 2025: 7 · 2024: 8 · 2023: 9 · 2022: 1
FWCI
2.62
Type
journal article
Language
en
Open access
Locations
  • Frontiers in Oncology (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion, cc-by)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
  • Radboud Repository (Radboud University) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion, other-oa)
Funders
  • ZonMw (95104001)
  • KWF Kankerbestrijding (2014-6617)
Topics
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
  • Health Sciences › Medicine › Oncology › Colorectal Cancer Surgical Treatments
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Genetic factors in colorectal cancer
Keywords
colon cancer, imatinib, neoadjuvant therapy, mesenchymal subtype, epithelial-mesenchymal transition, gene expression changes, survival, molecular subtyping

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