Building personalized treatment plans for early-stage colorectal cancer patients

Hung Hsin Lin, Nien Chih Wei, Teh Ying Chou, Chun Chi Lin, Yuan Tsu Lan, Shin Ching Chang, Huann Sheng Wang, Shung Haur Yang, Wei Shone Chen, Tzu Chen Lin, Jen Kou Lin, Jeng Kai Jiang*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


We developed a series of models to predict the likelihood of recurrence and the response to chemotherapy for the personalized treatment of stage I and II colorectal cancer patients. A recurrence prediction model was developed from 235 stage I/II patients. The model successfully distinguished between high-risk and low-risk groups, with a hazard ratio of recurrence of 4.66 (p < 0.0001). More importantly, the model was accurate for both stage I (hazard ratio = 5.87, p = 0.0006) and stage II (hazard ratio = 4.30, p < 0.0001) disease. This model performed much better than the Oncotype and ColoPrint commercial services in identifying patients at high risk for stage II recurrence. And unlike the commercial services, the robust model included recurrence prediction for stage I patients. As stage I/II CRC patients usually do not receive chemotherapy, we generated chemotherapy efficacy prediction models with data from 358 stage III patients. The predictions were highly accurate: the hazard ratio of recurrence for responders vs. non-responders was 4.13 for those treated with FOLFOX (p < 0.0001), and 3.16 (p = 0.0012) for those treated with fluorouracil. We have thus created a prognostic model that accurately identifies patients at high risk for recurrence, and the first accurate chemotherapy efficacy prediction model for individual patients. In the future, complete personalized treatment plans for stage I/II patients may be developed if the drug prediction models generated from stage III patients are verified to be effective for stage I and II patients in prospective studies.

Original languageEnglish
Pages (from-to)13805-13817
Number of pages13
Issue number8
StatePublished - 2017


  • Colorectal cancer
  • Drug efficacy
  • Microarray
  • Personalized treatment
  • Recurrence


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