Background: 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.
Keywords: Biomarker; Sequencing; Stage II; Stage III; Tumor evolution.
Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.