Distinct molecular and clinical aggressiveness in very early-onset metastatic colorectal cancer: survival and genomic divergence between patients aged 30-39 versus 40-49 years.
Very young adults with metastatic colorectal cancer show distinct biology and worse outcomes, arguing for age-specific treatment strategies and screening approaches.
This multi-institutional analysis of 264 metastatic early-onset CRC patients demonstrates that the 30-39 age group constitutes a genomically distinct subtype with shorter survival, KRAS enrichment, APC depletion, and greater peritoneal involvement compared to the 40-49 group. These findings support stratifying EOCRC by age decade for future trials and may inform targeted screening or treatment escalation in the youngest patients.
What the study was
- Study design
- Multi-institutional retrospective cohort with genomic profiling
- Population
- Metastatic early-onset CRC patients 30-39 years (n=65) vs 40-49 years (n=199)
- Sample size
- 264
- Category
- Genomics/Precision Medicine
- Maturity
- Validated
- Journal
- ESMO Open
Why it surfaced
Identifies a genomically distinct ultra-young mCRC subtype with worse prognosis; FoundationOne comprehensive genomic profiling; multi-Italian institutional collaboration; implications for guideline age cutoffs.
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