Prediction of long-term recurrence-free and overall survival in early-onset colorectal cancer: the ENCORE multi-centre study
Survivors of early-onset colorectal cancer (EOCRC, i.e., diagnosed before age 50) are likely to experience recurrence after completing treatment. In this international, multi-centric, phase I-II-III EDRN biomarker study, we identified a panel of tumor-derived biomarkers of EOCRC recurrence. We then trained and independently validated a machine learning model (XGBoost) to predict 5-year recurrence-free and overall survival (RFS and OS) of patients with stage I-III EOCRC. Patients with "low-risk" EOCRC demonstrated statistically higher rates of 2-, 5-, and 10 year RFS in both the training cohort (51.0 vs. 92.4%; 34.4% vs. 92.4%; 25.8% vs. 92.4%, respectively; p < 0.0001) and the validation cohort (78.9% vs. 100.0%; 75.0% vs. 100.0%; 75.0% vs. 100.0%, respectively; p = 0.0019). We also report a significant reduction in both over-treatment and missed recurrences compared to current clinically available options. This tissue-based, machine learning-powered assay was prognostic of long-term RFS and OS outcomes after curative-intent treatment of EOCRC (ENCORE was first registered on ClinicalTrial.gov [ID: NCT06271980] on February 15th, 2024).
Authors
- Jinfei Chen
- Hiroyuki Uetake (ORCID: https://orcid.org/0000-0001-7162-6842)
- Giulia Martina Cavestro (ORCID: https://orcid.org/0000-0003-1947-9368)
- Enrique Quintero (ORCID: https://orcid.org/0000-0002-7244-8125)
- Francesc Balaguer (ORCID: https://orcid.org/0000-0002-0206-0539)
- Alessandro Mannucci (ORCID: https://orcid.org/0000-0002-1655-6762)
- Yasuhide Yamada (ORCID: https://orcid.org/0000-0003-0692-8419)
- Tianhui Chen (ORCID: https://orcid.org/0000-0003-4677-0361)
- Goretti Hernández (ORCID: https://orcid.org/0000-0003-2203-8774)
- Hideo Baba (ORCID: https://orcid.org/0000-0002-3474-2550)
- Ajay Goel (ORCID: https://orcid.org/0000-0003-1396-6341)
- C. Richard Boland
Institutions
- Tokyo Medical and Dental University (JP)
- Vita-Salute San Raffaele University (IT)
- Chinese Academy of Sciences (CN)
- Wenzhou Medical University (CN)
- American Gastroenterological Association (US)
- Hospital Universitario de Canarias (ES)
- First Affiliated Hospital of Wenzhou Medical University (CN)
- Baylor University Medical Center (US)
- University of California San Diego (US)
- Zhejiang Cancer Hospital (CN)
- City of Hope (US)
- Baylor Medical Center at Garland (US)
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (ES)
- National Cancer Center Hospital East (JP)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele (IT)
- Beckman Research Institute
- Kumamoto University (JP)
Publication Details
- Journal
- npj Precision Oncology
- Published
- 2025-06-21
- DOI
- https://doi.org/10.1038/s41698-025-00978-7
- Citations
- 5
- Primary Topic
- Genetic factors in colorectal cancer
- Type
- article
- Field-Weighted Citation Impact
- 7.36
Funders
- Fundación Mapfre
- Università degli Studi di Padova
- National Institutes of Health
- National Cancer Institute