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MDxHealth SA Epigenetic Marker as Companion Diagnostic for Irinotecan based Therapy in Colorectal Cancer
MDxHealth SA announced data showing that methylation of the Decoy Receptor 1 (DCR1) gene may help guide oncologists in selecting metastatic colorectal cancer (CRC) patients to receive irinotecanbased therapy. The data, presented on June 2nd at the 49th Annual Meeting of the American Society of Clinical Oncology (ASCO) in Chicago, USA, showed that CRC patients with methylated DCR1 did not benefit from the addition of irinotecan to capecitabine therapy. Identification of DCR1 as a novel hypermethylated gene associated with a lack of benefit in adding irinotecan to capecitabine when treating metastatic colorectal cancer was performed in the pathology department of Prof. Gerrit Meijer (VUmc, Amsterdam) as part of the CTMM public-private partnership DeCoDe (Decrease Colorectal Cancer Death) project. The presence of DNA methylation for a selected panel of 22 genes was assessed on primary tumors of 185 patients with metastatic CRC treated with firstline capecitabine (CAP, n=90) or a combination of capecitabine and irinotecan (CAPIRI, n=95) in the phase 3 CAIRO trial. Methylation status of each gene was correlated to progression free survival (PFS) by treatment regimen. Genes for which methylation status was associated with response to irinotecan were validated in 166 patients treated with firstline CAP (n=78) or CAPIRI (n=88). In CAPIRI treated patients, DCR1 methylation was correlated to a shorter PFS compared to patients with unmethylated DCR1 (hazard ratio HR=0.4, p = 0.0009).
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