Personalized risk stratification in colorectal cancer via PIANOS system
Abstract Current prognostic biomarkers for colorectal cancer (CRC) lack stability and generalizability across different cohorts and platforms, challenging precise patient stratification. Here, we introduce a Platform Independent and Normalization Free Single-sample Classifier (PIANOS), designed to r...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2025-07-01
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| Series: | Nature Communications |
| Online Access: | https://doi.org/10.1038/s41467-025-61713-1 |
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| author | Du Cai Haoning Qi Qiuxia Yang Huayu Li Chenghang Li Chuling Hu Baowen Gai Xu Zhang Yize Mao Feng Gao Xiaojian Wu |
| author_facet | Du Cai Haoning Qi Qiuxia Yang Huayu Li Chenghang Li Chuling Hu Baowen Gai Xu Zhang Yize Mao Feng Gao Xiaojian Wu |
| author_sort | Du Cai |
| collection | DOAJ |
| description | Abstract Current prognostic biomarkers for colorectal cancer (CRC) lack stability and generalizability across different cohorts and platforms, challenging precise patient stratification. Here, we introduce a Platform Independent and Normalization Free Single-sample Classifier (PIANOS), designed to refine treatment decisions by accurately categorizing patients with CRC into distinct risk groups. Developed using gene expression data from 562 patients and employing a rank-based k-Top Scoring Pairs (k-TSP) algorithm alongside resampling, PIANOS was rigorously validated in 15 cohorts comprising 3666 patients with CRC. It effectively differentiates high-risk from low-risk patients, outperforms 105 existing models, and demonstrates robust performance across technologies like microarrays and RNA sequencing. PIANOS-based stratification is validated as an independent predictor of disease-free survival. Moreover, PIANOS discriminates treatment responses across risk categories, with high-risk patients showing increased sensitivity to bevacizumab and low-risk patients exhibiting enhanced responsiveness to chemotherapy and immunotherapy. This study reports significant advancements in supporting clinical decision-making for CRC and provides a reliable framework for optimizing patient treatment strategies. |
| format | Article |
| id | doaj-art-36b6d1dd421a4e2a90e65958de7dd8b4 |
| institution | DOAJ |
| issn | 2041-1723 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Nature Communications |
| spelling | doaj-art-36b6d1dd421a4e2a90e65958de7dd8b42025-08-20T03:05:06ZengNature PortfolioNature Communications2041-17232025-07-0116111810.1038/s41467-025-61713-1Personalized risk stratification in colorectal cancer via PIANOS systemDu Cai0Haoning Qi1Qiuxia Yang2Huayu Li3Chenghang Li4Chuling Hu5Baowen Gai6Xu Zhang7Yize Mao8Feng Gao9Xiaojian Wu10Department of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen UniversityDepartment of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen UniversityDepartment of Radiology, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterArtificial Intelligence Thrust, The Hong Kong University of Science and TechnologyDepartment of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen UniversityDepartment of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen UniversityCenter for Reproductive Medicine, Chongqing Reproductive Genetics Institute, Chongqing Health Center for Women and Children, Women and Children’s Hospital of Chongqing Medical UniversityDepartment of Pancreatobiliary Surgery, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer CenterDepartment of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen UniversityDepartment of General Surgery (Colorectal Surgery), The Sixth Affiliated Hospital, Sun Yat-sen UniversityAbstract Current prognostic biomarkers for colorectal cancer (CRC) lack stability and generalizability across different cohorts and platforms, challenging precise patient stratification. Here, we introduce a Platform Independent and Normalization Free Single-sample Classifier (PIANOS), designed to refine treatment decisions by accurately categorizing patients with CRC into distinct risk groups. Developed using gene expression data from 562 patients and employing a rank-based k-Top Scoring Pairs (k-TSP) algorithm alongside resampling, PIANOS was rigorously validated in 15 cohorts comprising 3666 patients with CRC. It effectively differentiates high-risk from low-risk patients, outperforms 105 existing models, and demonstrates robust performance across technologies like microarrays and RNA sequencing. PIANOS-based stratification is validated as an independent predictor of disease-free survival. Moreover, PIANOS discriminates treatment responses across risk categories, with high-risk patients showing increased sensitivity to bevacizumab and low-risk patients exhibiting enhanced responsiveness to chemotherapy and immunotherapy. This study reports significant advancements in supporting clinical decision-making for CRC and provides a reliable framework for optimizing patient treatment strategies.https://doi.org/10.1038/s41467-025-61713-1 |
| spellingShingle | Du Cai Haoning Qi Qiuxia Yang Huayu Li Chenghang Li Chuling Hu Baowen Gai Xu Zhang Yize Mao Feng Gao Xiaojian Wu Personalized risk stratification in colorectal cancer via PIANOS system Nature Communications |
| title | Personalized risk stratification in colorectal cancer via PIANOS system |
| title_full | Personalized risk stratification in colorectal cancer via PIANOS system |
| title_fullStr | Personalized risk stratification in colorectal cancer via PIANOS system |
| title_full_unstemmed | Personalized risk stratification in colorectal cancer via PIANOS system |
| title_short | Personalized risk stratification in colorectal cancer via PIANOS system |
| title_sort | personalized risk stratification in colorectal cancer via pianos system |
| url | https://doi.org/10.1038/s41467-025-61713-1 |
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