GI-Cancer: CMS classification could determine treatment
Consensus molecular subtypes (CMS) are currently used as a transcriptome-based classification of colorectal cancer (CRC) with prognostic significance, yet it is unknown if there is an association with treatment outcomes, especially in metastases. A retrospective analysis of phase 3 of the MAX clinical trial investigated whether CMS classification predicted treatment benefit of bevacizumab (B) in first line treatment of metastatic CRC.
Archival tumors from 239 patients (51 % of trial population) were deemed suitable for analysis. The tumors were classified into CMS groups 1-4. The CMS groups were correlated with progression free survival (PFS) in the MAX trial. The predictive value of CMS was determined as the interaction between CMS and bevacizumab treatment, assessed by Cox proportional hazards model.
In metastatic CRC, the CMS subtypes 2 and 3 benefitted more from the addition of bevacizumab to chemotherapy in comparison to CMS subtypes 1 and 4. Nevertheless validation is required through independent cohorts so that CMS classification can be used as a deciding factor to treat metastatic CRC with bevacizumab in the future.