Biomarkers. 2025 Jan 09. 1-13
Jumanah Yousef Alshenaifi,
Guglielmo Vetere,
Giulia Maddalena,
Mahmoud Yousef,
Michael G White,
John Paul Shen,
Eduardo Vilar,
Christine Parseghian,
Arvind Dasari,
Van Karlyle Morris,
Ryan Huey,
Michael J Overman,
Robert Wolff,
Kanwal P Raghav,
Jason Willis,
Kristin Alfaro,
Andy Futreal,
Y Nancy You,
Scott Kopetz.
INTRODUCTION: Colorectal cancer (CRC) incidence and mortality before 50 have been rising alarmingly in the recent decades.
METHODS: Using a cohort of 10,000 patients, this study investigates the clinical, mutational, and co-mutational features of CRC in early-onset (EOCRC, < 50 years) compared to late-onset (LOCRC, ≥ 50 years).
RESULTS: EOCRC was associated with a higher prevalence of Asian and Hispanic patients, rectal or left-sided tumors (72% vs. 59%), and advanced-stage disease. Molecular analyses revealed differences in mutation patterns, with EOCRC having higher frequencies of TP53 (74% vs. 68%, p < 0.01) and SMAD4 (17% vs. 14%, p = 0.015), while BRAF (5% vs. 11%, p < 0.001) and NOTCH1 (2.7% vs. 4.1%, p = 0.01) mutations were more prevalent in LOCRC. Stratification by tumor site and MSI status highlighted significant location- and age-specific molecular differences, such as increased KRAS and CTNNB1 mutations in right-sided EOCRC and higher BRAF prevalence in MSI-H LOCRC (47% vs. 6.7%, p < 0.001). Additionally, co-occurrence analysis revealed unique mutational networks in EOCRC MSS, including significant co-occurrences of FBXW7 with NOTCH3, RB1, and PIK3R1.
CONCLUSION: This study highlights the significance of age-specific molecular profiling, offering insights into the unique biology of EOCRC and potential clinical applications.
Keywords: APC; Early-onset colorectal cancer; NGS; TP53; late-onset colorectal cancer; next-generation sequencing