Colorectal cancer ranks third in incidence worldwide but second in mortality (1). In China,colorectal cancer is the second most common cancer and the most prevalent gastrointestinal malignancy,with both incidence and mortality continuing to rise (2). In 2017,the Chinese Society of Clinical Oncology (CSCO) issued its guidelines for colorectal cancer. These guidelines are updated annually to incorporate the latest clinical research findings,therapeutic agents,and expert opinions (3-8). This article describes the updates made in the 2026 version compared with the 2025 version.

TPS159 Background: The liver is the most common site of metastasis in colorectal cancer, and liver metastases represent the primary cause of death among these patients. Achieving no evidence of disease (NED) to attain a disease-free state can significantly prolong overall survival. This study aims to evaluate the conversion rate and safety of adding tislelizumab to standard therapy regimens in patients with initially unresectable CRLM. Methods: This study enrolled patients with MSS-type CRLM. After the MDT assessed and confirmed potentially resectable disease, patients were stratified into two cohorts based on RAS status. The RAS wild-type cohort received tislelizumab combined with cetuximab and FOLFOX. The RAS mutant cohort received tislelizumab combined with bevacizumab and CAPOX. The primary endpoint was the conversion rate, and secondary endpoints included objective response rate (ORR), disease free survival (DFS) and safety. This clinical trial was registered at ClinicalTrials.gov (NCT05409417). Clinical trial information: NCT05409417 .

e15602 Background: To date, immune-checkpoint inhibitors remain ineffective for patients with proficient mismatch repair/microsatellite stable (pMMR/MSS), metastatic colorectal cancer (mCRC). Chemotherapy plus targeted therapy represents standardized therapeutic regimens in second-line treatment of patients with pMMR/MSS mCRC. Preclinical and clinical studies have suggested that addition of immune-checkpoint inhibitors to standardized treatments have synergistic therapeutic effects in pMMR/MSS mCRC, especially in RAS-mutant patients. Therefore, this study aims to investigate whether the addition of cadonilimab (a humanized bispecific antibody targeting both PD-1 and CTLA-4) to chemotherapy and bevacizumab as second-line treatment could improve efficacy while maintaining safety in pMMR/MSS, RAS-mutant mCRC patients. Methods: This open-label, single-arm, multi-center study enrolled eligible patients with pMMR/MSS, RAS-mutant mCRC patients, aged 18-75, who were previously treated with oxaliplatin-based chemotherapy as first-line treatment, had at least one measurable lesion according to RECIST 1.1, ECOG performance status (PS) of 0–1, and adequate organ function. Participants received cadonilimab (6 mg/kg) plus FOLFIRI and bevacizumab (5 mg/kg) for up to twelve 14-day cycles, followed by maintenance therapy including cadonilimab and fluoropyrimidine with bevacizumab until PD or unacceptable toxicities. The primary endpoint was objective response rate (ORR) per RECIST 1.1 by investigator review. The secondary endpoints included disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety and tolerability. Results: In total, 32 eligible patients were enrolled between February 2024 to December 2025 from three centers. Among the 27 efficacy-evaluable patients, the regimen yielded an objective response rate (ORR) of 44.4% (12/27) and a disease control rate (DCR) of 70% (19/27). Median progression-free survival (PFS) and overall survival (OS) have not yet been reached. Grade ≥3 treatment-related adverse events (TRAEs) occurred in 7 of 32 patients (21.9%). The most common TRAE was decreased neutrophil count, followed by diarrhea, fatigue, infusion-related reaction and elevated alanime aminotransferase. Conclusions: Cadonilimab plus chemotherapy and bevacizumab shows an encouraging clinical efficacy and tolerable safety as second-line treatment among pMMR/MSS, RAS-mutant mCRC patients. Clinical trial information: NCT07253896 .

Abstract The liver is the primary target organ for hematogenous metastasis of colorectal cancer, and colorectal cancer liver metastasis is one of the key and challenging aspects in its treatment. In order to improve the diagnosis and comprehensive treatment of colorectal cancer liver metastasis, the guideline development group has summarized advanced experiences and the latest achievements from both domestic and international sources, and has once again revised and updated the Guideline for the diagnosis and comprehensive treatment of colorectal cancer liver metastases (2025 edition) to continuously provide guidance and reference for clinical practice in this field.

AIM:Anastomotic leakage (AL) is a devastating complication following anterior rectal resection. This study aimed to evaluate whether a strategy utilizing real-time Laser Speckle Contrast Imaging (LSCI) for intraoperative perfusion assessment could reduce the incidence of AL. METHODS:We conducted a single-centre study comparing a prospective cohort undergoing LSCI-guided surgery (LSCI group) with a historical cohort (retrospective group). Propensity score matching (PSM) was used to balance baseline characteristics. The LSCI system was used to objectively assess bowel perfusion and guide the selection of the proximal transection site. The primary outcome was the rate of anastomotic leakage. RESULTS:After PSM, 105 patients in the LSCI group were matched with 176 patients in the control group, with all baseline characteristics being comparable. The incidence of AL was significantly lower in the LSCI group compared to the control group (1.9% vs. 8.5%, p < 0.05). Furthermore, the rate of severe postoperative infective complications requiring major intervention (percutaneous drainage or reoperation) was also significantly reduced in the LSCI group (1.9% vs. 9.6%; p = 0.02). In the LSCI group, real-time perfusion assessment led to an intraoperative change of the planned anastomotic site in 6 patients (5.7%), predominantly in low-to-middle rectal cancer cases. CONCLUSION:The use of an LSCI-guided strategy for real-time intraoperative perfusion assessment may reduce the rates of both AL and severe postoperative infective complications undergoing ARR surgery. This objective, quantitative technology is a valuable tool for optimizing surgical decision-making and improving patient outcomes.

BackgroundAlthough the fecal immunochemical test (FIT) is widely utilized in colorectal cancer (CRC) screening because of its noninvasive, rapid, and cost-effective characteristics, its effectiveness in post-adenoma resection surveillance remains unclear. This study aims to evaluate the benefits of follow-up FIT surveillance in individuals with adenoma resection and to identify risk factors associated with adenoma recurrence.Methods and findingsAs part of China's National Screening Project, we identified a total of 5,911 individuals who underwent adenoma removal during the first round of CRC screening in Jiashan and Haining between 2006 and 2021. All individuals with adenoma removal were invited to participate in a second CRC screening; 2,448 accepted and chose either direct colonoscopy surveillance (n = 989) or FIT surveillance (n = 1,459), while 3,463 declined. The Clone-Censor-Weight method was applied to mitigate time-related biases. Cox proportional hazards and Poisson regression models were used to evaluate the benefits of follow-up surveillance strategies after adenoma resection, adjusting for age, sex, baseline adenoma grade, family history of CRC in first-degree relatives, symptoms, chronic appendicitis or cholecystitis, and stressful life events. Additionally, we examined the risk factors associated with adenoma recurrence using logistic regression. The outcomes were the long-term incidence of CRC and the recurrence of adenomas following adenoma resection. Over average follow-up of 7.79 and 7.46 years, participants who underwent protocol-adherent follow-up FIT surveillance had a 44% lower CRC risk (hazard ratio [HR] = 0.56, 95% confidence interval [CI]: 0.31, 0.98; p = 0.044), and those who underwent direct colonoscopy had a 51% lower risk (HR = 0.49, 95% CI [0.27, 0.89]; p = 0.019), compared to individuals who refused follow-up surveillance. Compared with the direct follow-up colonoscopy group (53.56 per 100,000 person-years), the long-term CRC incidence rates were 70.38 for the follow-up negative FIT group and 80.14 for the positive FIT with adherence to colonoscopy group, with no statistically significant differences (p = 0.852; p = 0.834). Notably, participants who did not undergo colonoscopy following a positive FIT had a significantly increased CRC risk compared to those in the direct follow-up colonoscopy group, with an adjusted incidence rate ratio (aIRR) of 6.64 (95% CI [1.11, 39.83]; p = 0.038). Alcohol consumption (nondrinkers versus >3 times per week: adjusted odds ratio [aOR] = 0.43, 95% CI [0.27, 0.69]; p < 0.001) was associated with adenoma recurrence. Moreover, smoking (current smokers versus nonsmokers: aOR = 3.72, 95% CI [1.19, 11.60]; p = 0.024), obesity (obese versus normal: aOR = 3.21, 95% CI [1.17, 8.80]; p = 0.023), and having advanced adenomas at baseline (aOR = 3.30, 95% CI [1.41, 7.69]; p = 0.006) were associated with recurrence of advanced adenomas. Given the limited number of incident CRC cases and the observational study design, conclusions regarding the impact of follow-up FIT surveillance after adenoma removal should be interpreted with caution.ConclusionProtocol-adherent follow-up FIT surveillance after adenoma removal was associated with reduced long-term CRC risk, comparable to that observed with direct colonoscopy. However, improving adherence to colonoscopy after a positive FIT surveillance is crucial.

157 Background: Although immunotherapy has changed the treatment strategy for many cancers with great success, patients with microsatellite stable (MSS) and RAS-mutant metastatic colorectal cancer (mCRC) especially with liver metastases have a low response rate to immunotherapy. Sintilimab plus bevacizumab and CapeOX (BBCAPX) has proved its efficacy and safety in above unresectable mCRC patients (1). Here, we report subgroup analysis of updated survival results of this single arm, open-label, phase 2 trial. Methods: Eligible patients were histologically confirmed unresectable metastatic colorectal adenocarcinoma by multidisciplinary team, and had RAS gene mutation and confirmed MSS status. All patients received treatment with sintilimab plus bevacizumab, oxaliplatin and capecitabine of each 21-day cycle. ORR, DCR, PFS, OS, and subgroup analyses based on metastasis site were performed. Results: From April 2021 to December 2021, 25 patients were enrolled. The ORR was 84% and the DCR was 100%. Six (24%) patients including 5 patients with liver single organ metastases underwent surgical treatment and unexpectedly achieved no evidence of disease status. At the data cut-off day (September 13, 2024), patients with liver single organ metastases presented better prognosis. Median PFS was 25.3 months (95% CI, 4.8-NA) in the patients with liver single organ metastases and 11.5 months (95% CI, 4.83-24.3) in the patients with other metastasis. Median OS was not reached in the patients with liver single organ metastases and 35.5 months (95% CI, 9.36-NA) in the patients with other metastasis. The OS rate at 24 months was 72% (95% CI, 56.4-91.9) in FAS. Median OS was not reached in FAS and 35.5 months (95% CI, 11.4-NA) in PPS. 32% patients had at least one grade 3 or 4 TRAEs. No grade 5 adverse events occurred during the study. Conclusions: This study provides a highly promising regimen for patients with RAS-mutant, MSS, unresectable mCRC, especially those with liver single organ metastases. Furthermore, we are launching a phase III, randomized, open-label, multicentric clinical trial (NCT05171660) to further analyze the effects, safety, and prognostic biomarkers of this regimen. 1. Xuefeng Fang et al. ASCO 2022. Clinical trial information: NCT04194359 . PFS and OS results of BBCAPX-II study. Median PFS 6m PFS rate (%) 12m PFS rate (%) Median OS 12m OS rate (%) 24m OS rate (%) Full analysis set (FAS), n = 25 17.9 (95% CI, 8.84-27) 84 (70.8-99.7) 56 (39.6-79.3) NA 76 (61-94.7) 72 (56.4-91.9) Per-protocol set (PPS), n = 19 9.79 (95% CI, 6.44-27.9) 78.9 (62.6-99.6) 42.1 (24.9-71.3) 35.5 (95% CI, 11.4-NA) 68.4 (50.4-92.9) 63.2 (44.8-89) Classified by metastatic organs (FAS, n = 25) Liver single organ metastases, n = 10 25.3 (95% CI, 4.8-NA) 90 (73.2-100) 70 (46.7-100) NA (11.4-NA) 90 (73.2-100) 80 (58.7-100) Other metastases, n = 15 11.5 (95% CI, 4.83-24.3) 80 (62.1-100) 46.7 (27.2-80.2) 35.5 (9.36-NA) 66.7 (46.6-95.3) 66.7 (46.6-95.3)

Up to 50% of patients with metastatic microsatellite instability-high (MSI-H) colorectal cancer (CRC) are resistant to immunotherapy and experience progression or recurrence after treatment. We integrated the genomic, epigenomic, transcriptomic, and proteomic data for 99 patients in a Chinese MSI-H CRC cohort. Proteomic profiling of primary tumors clearly classified MSI-H tumors into 2 subtypes. We found that the 2 subtypes have different mutational signatures, enriched pathways, gene fusion networks, and clinical outcomes. Notably, NCAM1 could serve as a potential biomarker for checkpoint inhibitor response in MSI-H CRC. Thus, there is an urgent need to stratify the MSI-H group into different subtypes and adopt more targeted therapies to prolong patient survival.

The National Health Commission of the People's Republic of China Guidelines for Diagnosis and Treatment of Colorectal Cancer (2025 edition), based on evidence-based medicine, integrates cutting-edge international advances with Chinese clinical practice, and supplements and completes the previous versions. This version of the guidelines, retains the core diagnostic and treatment framework, highlights new contents such as "Surgical treatment of anal canal cancer" and "New technologies and advances in diagnosis and treatment", and systematically summarizes the core points in the surgical treatment, medical oncology treatment, radiation oncology treatment, imaging, and pathology treatment. It is designed to help clinicians quickly grasp the key points of the guidelines and promote the standardization, precision, and consistence of colorectal cancer diagnosis and treatment.

psiTPTE22-HERV is a human-specific gene with unexplored functions. This study investigated its regulation, molecular mechanism, and clinical significance in gastric cancer. psiTPTE22-HERV expression was consistently down-regulated in primary tumors and cancer cell lines across various cancer types, including gastric cancer, as indicated by TCGA data and quantitative PCR analysis. Its down-regulation in gastric cancer cells is mediated by promoter methylation, confirmed through bisulfite genomic sequencing, with expression restored following demethylation treatment. A progressive reduction in psiTPTE22-HERV expression was observed from normal stomach mucosa to adjacent non-tumor tissues and primary tumors, along with increased methylation. psiTPTE22-HERV inhibited cancer cell viability, clonogenicity, cell cycle progression, migration, and invasion while promoting apoptosis. It also suppressed subcutaneous tumor growth and distant metastasis in mice. Transcriptomic analysis revealed that psiTPTE22-HERV disrupted PI3K/AKT/mTOR signaling. Western blotting confirmed that psiTPTE22-HERV reduced protein levels of PI3K, p-AKT, and mTOR. This led to the down-regulation of EIF4E and EIF4EBP1, oncogenic protein synthesis genes and effectors of mTOR signaling, as well as p-EIF4EBP1(Thr70), which is regulated by mTOR. Notably, psiTPTE22-HERV expression was inversely correlated with EIF4E, EIF4EBP1, and p-EIF4EBP1 (Thr70) in gastric tumors (all P < 0.001). Multivariate analysis revealed that psiTPTE22-HERV expression in primary gastric tumors independently predicted survival (P = 0.027). Kaplan-Meier survival analysis showed that low psiTPTE22-HERV expression was associated with shortened survival in gastric cancer patients (P = 0.0009). Overall, psiTPTE22-HERV plays a tumor-suppressive role by inhibiting the PI3K/AKT/mTOR/EIF4E pathway, and its down-regulation serves as an independent marker for poor prognosis in gastric cancer patients.

Colorectal cancer prevention and treatment in China, which is akin to population screening for colorectal cancer in the Western world, began approximately fifty years ago. In the 1970s, the National Ministry of Health initiated the first comprehensive survey for all causes of death in China's mainland. The counties with the highest rates of colorectal cancer mortality in the survey were identified as high-risk areas for colorectal cancer, where the inaugural population screening for colorectal cancer in China's mainland was conducted. There was a high moment of colorectal cancer population screening in the 1970s and 1980s. Colorectal cancer screening was focused on high-risk areas. The medical doctors, scholars, and community health workers at that time embraced it very enthusiastically. However, it fell silent in the 1990s. Until 2005, a new project was established by the Center for Disease Control and Prevention of China. In that project, a small number of cities and counties across China were selected as pioneers to implement population screening for colorectal cancer. The feasibility of organized mass screening for colorectal cancer that was fully supported by government funding was tested. Since then, population screening for colorectal cancer in China has entered a new stage. The progress in the development of population screening for colorectal cancer is remarkable compared to that of other types of cancer in recent years. The size of the population undergoing screening for colorectal cancer in China continued to increase. In the early 2010s, some major cities such as Shanghai, Tianjin, and Guangzhou expanded the coverage of colorectal cancer screening from a limited area to encompass the entire administrative region. More and more research agencies, research programs, and academic papers in this field have emerged. Many new technologies and products for colorectal cancer screening are being developed and marketed in China. However, concerns also arise regarding these notable developments. Firstly, a fair evaluation of the meaningful outcomes was lacking. The screening strategy being used in China's mainland is quite different from that in the Western world. However, there are very few well-designed cohort or randomized controlled studies to evaluate the impact of the current population screening strategy on the incidence and mortality of colorectal cancer. Moreover, colorectal cancer incidence and mortality in China's mainland are still increasing. Secondly, the contradiction between public interest and business benefits in colorectal cancer screening has surfaced during the marketing of new screening products. The inappropriate promotion of new products could hinder efforts to increase the screening rate in the general population. Thirdly, the role of direct colonoscopy in colorectal cancer screening might be underestimated and the quality of colonoscopy needs to be improved. Finally, too many resources are placed on the early diagnosis and treatment of colorectal cancer, while the importance of colorectal cancer prevention through lifestyle changes has yet to be emphasized. We may encounter patients with these developmental issues during population screening for colorectal cancer in China's mainland. However, we should also be cautious about behaviors that could mislead us on the way to fulfilling our primary goal.

The 2024 updates of the Chinese Society of Clinical Oncology (CSCO) Clinical Guidelines for the diagnosis and treatment of colorectal cancer emphasize standardizing cancer treatment in China, highlighting the latest advancements in evidence-based medicine, healthcare resource access, and precision medicine in oncology. These updates address disparities in epidemiological trends, clinicopathological characteristics, tumor biology, treatment approaches, and drug selection for colorectal cancer patients across diverse regions and backgrounds. Key revisions include adjustments to evidence levels for intensive treatment strategies, updates to regimens for deficient mismatch repair (dMMR)/ microsatellite instability-high (MSI-H) patients, proficient mismatch repair (pMMR)/ microsatellite stability (MSS) patients who have failed standard therapies, and rectal cancer patients with low recurrence risk. Additionally, recommendations for digital rectal examination and DNA polymerase epsilon (POLE)/ DNA polymerase delta 1 (POLD1) gene mutation testing have been strengthened. The 2024 CSCO Guidelines are based on both Chinese and international clinical research, as well as expert consensus, ensuring their relevance and applicability in clinical practice, while maintaining a commitment to scientific rigor, impartiality, and timely updates.

Ductal carcinoma in situ (DCIS) represents pre-invasive breast carcinoma. In untreated cases, 25-60% DCIS progress to invasive ductal carcinoma (IDC). The challenge lies in distinguishing between non-progressive and progressive DCIS, often resulting in over- or under-treatment in many cases. With increasing screen-detected DCIS in these years, the nature of DCIS has aroused worldwide attention. A deeper understanding of the biological nature of DCIS and the molecular journey of the DCIS-IDC transition is crucial for more effective clinical management. Here, we reviewed the key signaling pathways in breast cancer that may contribute to DCIS initiation and progression. We also explored the molecular features of DCIS and IDC, shedding light on the progression of DCIS through both inherent changes within tumor cells and alterations in the tumor microenvironment. In addition, valuable research tools utilized in studying DCIS including preclinical models and newer advanced technologies such as single-cell sequencing, spatial transcriptomics and artificial intelligence, have been systematically summarized. Further, we thoroughly discussed the clinical advancements in DCIS and IDC, including prognostic biomarkers and clinical managements, with the aim of facilitating more personalized treatment strategies in the future. Research on DCIS has already yielded significant insights into breast carcinogenesis and will continue to pave the way for practical clinical applications.

我国结直肠癌人群防治起步于50年前的癌症高发现场,曾有过热烈的大规模群防群治,也曾一度陷入沉寂。17年前重新出发,进入全新发展期。如今结直肠癌人群防治研究机构众多,各类项目不断涌现,学术研究活跃并量质齐升,更有一大批企业加入肠癌早筛新技术新产品研发和推广,呈现出癌症人群防治领域少有的欣欣向荣之势。但成绩背后有隐忧,新技术新产品推广浮现着公益与商业利益的矛盾,多样的学术观点隐含着不统一的认识,各级各类大量项目背后是对投入与实际产出的拷问。对于目前该领域中存在的一些问题,也许我们需要有一点耐心,但也应防止其发展背离初衷。

Background Colorectal cancer (CRC) is one of the most common cancers worldwide and is related to diet and obesity. Currently, crosstalk between lipid metabolism and CRC has been reported; however, the specific mechanism is not yet understood. In this study, we screened differentially expressed long non-coding RNAs (lncRNAs) and mRNAs from primary cancer, paracancer, and white adipose tissue of CRC patients. We screened and analyzed the genes differentially expressed between primary and paracancer tissue and between paracancer and white adipose tissue but not between primary and white adipose tissue. According to the results of the biological analysis, we speculated a lncRNA (MIR503HG) that may be involved in the crosstalk between CRC and lipid metabolism through exosome delivery. Methods We screened differentially expressed long non-coding RNAs (lncRNAs) and mRNAs from primary cancer, paracancer, and white adipose tissue of CRC patients. We screened and analyzed the genes differentially expressed between primary and paracancer tissue and between paracancer and white adipose tissue but not between primary and white adipose tissue. Results We speculated a lncRNA (MIR503HG) that may be involved in the crosstalk between CRC and lipid metabolism through exosome delivery. Conclusions In this study, the findings raise the possibility of crosstalk between lipid metabolism and CRC through the exosomal delivery of lncRNAs.

3563 Background: Microsatellite stable (MSS) and RAS-mutant metastatic colorectal cancer (mCRC) patients are characterized by an immunosuppressive microenvironment and a low response rate to immunotherapy. Sintilimab plus bevacizumab and CapeOX (BBCAPX) has proved its efficacy and safety in above unresectable mCRC patients (Ying Yuan et al. ASCO 2023 and Xuefeng Fang et al. ASCO 2022). Here, we report updated survival results of this single arm, open-label, phase 2 trial. Methods: Eligible patients were aged 18 to 75 years with histologically confirmed unresectable metastatic colorectal adenocarcinoma by multidisciplinary team, and had RAS gene mutation and confirmed MSS status. All patients received treatment with sintilimab (200 mg, day 1) plus bevacizumab (7.5mg/kg, day 1) and oxaliplatin (135 mg/m2, day 1) and capecitabine (1g/m2, bid, day 1-14) of each 21-day cycle. The primary endpoint included objective response rate (ORR) and adverse events. Secondary endpoint was disease control rate (DCR) and progression-free survival (PFS). Results: From April 2021 to December 2021, 25 patients were enrolled. The ORR was 84% and the DCR was 100%. Six (24%) patients underwent surgical treatment and unexpectedly achieved no evidence of disease status. At the data cut-off day (January 26, 2024), the median PFS in the full analysis set was 17.9 months (95% CI, 8.84-27), and the median PFS in the per-protocol set was 9.79 months (95% CI, 6.44-24.3). Median PFS was 23.7 months (95% CI, 4.8-NA) in the patients with only liver metastasis and 11.5 months (95% CI, 4.83-24.3) in the patients with other metastasis. The PFS rate at 6 months was 84% (95% CI, 70.8-99.7). The PFS rate at 12 months was 56% (95% CI, 39.6-79.3). The most frequent grade 3 or 4 TRAEs were neutropenia (3/25) and increased alanine transaminase (2/25). No grade 5 adverse events occurred during the study. Conclusions: The combination of sintilimab plus bevacizumab and CapeOx showed promising antitumor activity and manageable toxicity in RAS-mutant, MSS, unresectable mCRC. Patients with liver metastases presented better prognosis compared other metastases. Furthermore, we are currently launching a phase III, randomized, open-label, multicentric clinical trial (NCT05171660) to further analyze the effects, safety, and prognostic biomarkers of this regimen. Clinical trial information: NCT04194359 . [Table: see text]

PDF file, 67K, Primer sequences in RT-PCR analysis.

The objective of this study is to assess the predictive potency of cell senescence-related genes (CSRGs) in breast cancer (BC) and establish a risk signature. Trascriptome data of CSRGs were obtained from the TCGA and GEO databases. Consensus clustering was used to generate CSRGs-based molecular clusters for BC patients. A CSRGs-derived risk signature was built using multiple Cox regression analyses of differentially expressed genes (DEGs) between clusters. The prognosis, immune infiltration, chemotherapy and immunotherapy response between different risk groups were analyzed and compared. Two molecular clusters of BC patients were generated on the basis of 79 differentially expressed CSRGs, which showed distinct prognosis and immune infiltration. A total of 1403 DEGs between the CSRGs-derived clusters were found, and 10 of them were independent prognostic genes that used to construct a risk signature. The results demonstrated that patients with older age and advanced stage presented with a higher risk scores. In addition, the risk signature was found to be associated with outcomes, immune infiltration, chemotherapy and immunotherapy response. Patients in the low-risk group showed a favorable prognosis and higher immunotherapy response than those in the high-risk group. Finally, we developed a highly stable nomogram that incorporates risk signature, chemotherapy, radiotherapy, and stage variables, enabling accurate prediction of the overall survival (OS) of individual patients. To conclude, the signature derived from CSRGs holds great promise as a biomarker for prognostic assessment of BC and may serve as a valuable tool in guiding immunotherapy.

Perspective on This Article from Performance of a Colorectal Cancer Screening Protocol in an Economically and Medically Underserved Population