Colorectal cancer is a leading cause of cancer-related mortality, has a very broad mutational spectrum, and there is no clinically available biomarker that can predict which patients with stage II or stage III colorectal cancer will develop metastatic disease.Patients and Methods:
We used a targeted next-generation sequencing approach to analyze the mutational spectra in stage II and III colon cancer patient samples.Results:
Amidst a broad range of acquired mutations and variants, we found evidence of tumor heterogeneity that distinguished the tumors in different groups. When heterogeneity was quantified using the Mutant-Allele Tumor Heterogeneity (MATH) score, there was a strong correlation between higher MATH score and risk of metastases.Conclusions:
Measures of tumor heterogeneity might be useful biomarkers for identifying patients with colon cancer who are at risk of developing metastases. This might allow for more specific, tailored follow-up and adjuvant therapies after standard surgery.
There is no clinical biomarker that predicts which patients with stage II or III colon cancers are at risk for developing metastases. A bioinformatics approach using the Mutant-Allele Tumor Heterogeneity score for tumor heterogeneity might identify this high-risk subset of patients to tailor adjuvant therapies and surveillance.