WO2013096888A1 - Identification d'arnmi spécifiques à des métastases et signatures d'hypométhylation dans le cancer colorectal humain - Google Patents

Identification d'arnmi spécifiques à des métastases et signatures d'hypométhylation dans le cancer colorectal humain Download PDF

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WO2013096888A1
WO2013096888A1 PCT/US2012/071455 US2012071455W WO2013096888A1 WO 2013096888 A1 WO2013096888 A1 WO 2013096888A1 US 2012071455 W US2012071455 W US 2012071455W WO 2013096888 A1 WO2013096888 A1 WO 2013096888A1
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mir
expression
colorectal cancer
level
metastasis
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PCT/US2012/071455
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English (en)
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Ajay Goel
Richard C. Boland
Keun Hur
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Baylor Research Institute
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Priority to CA2859865A priority Critical patent/CA2859865A1/fr
Priority to EP12859326.6A priority patent/EP2794924B1/fr
Priority to AU2012358200A priority patent/AU2012358200B2/en
Priority to US14/367,827 priority patent/US10519506B2/en
Publication of WO2013096888A1 publication Critical patent/WO2013096888A1/fr

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    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12Q—MEASURING OR TESTING PROCESSES INVOLVING ENZYMES, NUCLEIC ACIDS OR MICROORGANISMS; COMPOSITIONS OR TEST PAPERS THEREFOR; PROCESSES OF PREPARING SUCH COMPOSITIONS; CONDITION-RESPONSIVE CONTROL IN MICROBIOLOGICAL OR ENZYMOLOGICAL PROCESSES
    • C12Q1/00—Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions
    • C12Q1/68—Measuring or testing processes involving enzymes, nucleic acids or microorganisms; Compositions therefor; Processes of preparing such compositions involving nucleic acids
    • C12Q1/6876—Nucleic acid products used in the analysis of nucleic acids, e.g. primers or probes
    • C12Q1/6883—Nucleic acid products used in the analysis of nucleic acids, e.g. primers or probes for diseases caused by alterations of genetic material
    • C12Q1/6886—Nucleic acid products used in the analysis of nucleic acids, e.g. primers or probes for diseases caused by alterations of genetic material for cancer
    • C—CHEMISTRY; METALLURGY
    • C12—BIOCHEMISTRY; BEER; SPIRITS; WINE; VINEGAR; MICROBIOLOGY; ENZYMOLOGY; MUTATION OR GENETIC ENGINEERING
    • C12Q—MEASURING OR TESTING PROCESSES INVOLVING ENZYMES, NUCLEIC ACIDS OR MICROORGANISMS; COMPOSITIONS OR TEST PAPERS THEREFOR; PROCESSES OF PREPARING SUCH COMPOSITIONS; CONDITION-RESPONSIVE CONTROL IN MICROBIOLOGICAL OR ENZYMOLOGICAL PROCESSES
    • C12Q2600/00—Oligonucleotides characterized by their use
    • C12Q2600/178—Oligonucleotides characterized by their use miRNA, siRNA or ncRNA

Definitions

  • the present invention relates in general to the field of cancer detection and diagnosis, and more particularly, to novel metastasis-specific miRNA and hypomethylation signatures in metastatic human colorectal cancer.
  • United States Patent Application Publication No. 20110183859 filed by Harris; et al., entitled, Inflammatory Genes and Microrna-21 as Biomarkers for Colon Cancer Prognosis, discloses methods for detecting a more aggressive form of a colon adenocarcinoma in a subject, thereby predicting the prognosis of the subject.
  • the methods taught include determining an inflammatory gene expression signature in the colon adenocarcinoma and/or the adjacent non- cancerous tissue.
  • the inflammatory genes include, but are not limited to, PRG1, ANXA1, IL-17a, IL-23a FOXP3, HLA-DRA, IL-10, CD68 and IL-12a.
  • the method further includes detecting expression of microRNA-21 (miR-21) in the colon adenocarcinoma. Altered expression of one or more of the inflammatory genes or miR-21 indicates the prognosis of the subject. Also provided were arrays consisting essentially of probes specific for PRG1, ANXA1, IL-17a, IL-23a, FOXP3, HLA-DRA, IL-10, CD68, IL- 12a and miR-21.
  • WO 201 1 128900A2 filed by Aviram, et al, entitled, Plasma Based Micro-RNA Biomarkers and Methods for Early Detection of Colorectal Cancer, discloses compositions, methods and kits for diagnosing cancer, specifically the diagnosis of colorectal cancer (CRC). More specifically, the invention provides simple assays, with high sensitivity and specificity for CRC, wherein a panel of microRNA (miRNA) are used as biomarkers.
  • miRNA microRNA
  • a method for diagnosing metastasis of CRC in a subject is taught in which the expression level of miRs selected from the group consisting of miR566, miR96, miR183, miR194, miR200a, miR200b, miR200c, miR203 and miR429, or combinations thereof, in a biological sample obtained from the subject, wherein a significant elevation in the expression levels of the miRNAs in the biological sample compared to control values indicates that said subject is afflicted with metastasis of CRC.
  • biomarkers included hsa-miR-16-2*, hsa- miR-25, hsa-miR-7, hsa-miR-93, hsa-miR-345, hsa-miR-409-3p, hsa-miR-671-3p and hsa-miR- 331-3p.
  • MicroRNA expression was analyzed with Agilent microarrays containing 723 human microRNA probes and they validated the expression level of differentially expressed microRNA using quantitative real-time PCR analysis, such as, hsa-miR-129*, hsa-miR-137, miR-15b, miR-181b, miR-19 and miR-200c.
  • the present invention includes a method for diagnosing or detecting colorectal cancer metastasis in a human subject comprising the steps of: obtaining one or more biological samples from the human subject; determining an Alu repeat methylation level for the one or more biological samples; and comparing the Alu repeat methylation level in the biological sample to an Alu repeat methylation control level from a normal non-cancerous sample, wherein a decrease in the Alu repeat methylation level is indicative of at least one of colorectal cancer disease progression or colorectal cancer metastasis.
  • the biological samples are selected from the group consisting of a tissue sample, a plasma sample, a fecal sample, a cell homogenate, a blood sample, one or more biological fluids, or any combinations thereof.
  • the Alu repeat methylation level is determined by quantitative bisulfite pyrosequencing, thin layer chromatography (TLC), high performance liquid chromatography (HPLC), mass spectrometry (MS), nanopore amperometry, nanopore sequencing, single-molecule, real-time (SM-RT) sequencing, endonuclease digestion, microarrays, matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry, and next-generation sequencing.
  • the Alu repeat methylation level is determined by measuring the expression status of miR-520c and miR-373 in the biological sample when compared to a normal non-cancerous sample from the human subject obtained from a human subject that does not have cancer.
  • the non-cancerous sample is from the same patient.
  • the metastatic cancer is a liver metastasis of a colorectal cancer.
  • the method further comprises the steps of: determining an expression level for the one or more biological samples for at least one first marker selected from let-7i, miR-lOb, miR-200b, miR-320a, and miR-518d and at least one second marker selected from miR-141, miR-200c, and miR-203; and comparing the expression levels of the first and second markers to the biological sample, wherein a decrease in the level of expression of the at least one first marker and an increase in the level of expression of the second marker when compared to the level of expression in a normal tissue sample is indicative of colorectal cancer metastasis.
  • the method further comprises the steps of treating the colorectal cancer with a therapeutic agent, obtaining one or more patient samples and determining if there has been a change in the expression of the one or more microRNAs, wherein a change in expression is indicative of colorectal cancer metastasis.
  • kits for determining a detection, prediction, or prognosis for colorectal cancer in a human subject comprising: a biomarker detecting reagent for measuring at least one first marker selected from let-7i, miR-lOb, miR- 320a, and miR-221 in a sample obtained from the human subject; and instructions for the use of the biomarker detecting reagent in the prognosis of colorectal cancer metastasis, wherein the instructions comprise providing step-by-step directions to compare the level of expression of let- 7i, miR-lOb, miR-320a, and miR-221 in the sample with the level of expression of let-7i, miR- 10b, miR-320a, and miR-221 from normal colorectal tissue, wherein high expression of at least on of let-7i or miR-320a is indicative of a good prognosis for the colorectal cancer, while the low expression of at least one of miR-lOb or mi
  • the biological samples are selected from the group consisting of a tissue sample, a plasma sample, a fecal sample, a cell homogenate, a blood sample, one or more biological fluids, or any combinations thereof.
  • the level of expression of let-7i, miR-lOb and miR-320a in primary colorectal cancer is prognostic of distant metastasis.
  • the level of expression of let-7i, miR-lOb correlated with the TNM stage.
  • a high level of expression of let-7i indicates a good prognosis for colorectal cancer survival.
  • a low level of expression of let-7i indicates a poor prognosis for colorectal cancer survival.
  • a high level of expression of at least one of let-7i or miR-320a is predictive of less cancer metastasis.
  • a low level of expression of at least one of miR-lOb or miR-221 is predictive of less cancer metastasis.
  • the metastatic cancer is a liver metastasis of a colorectal cancer.
  • the level of expression is determined by digital color- coded barcode technology analysis, microarray expression profiling, PCR, reverse transcriptase PCR, reverse transcriptase real-time PCR, quantitative real-time PCR, end-point PCR, multiplex end-point PCR, cold PCR, ice-cold PCR, mass spectrometry, or nucleic acid sequencing.
  • the method further comprises the detection of miR-122, wherein an increase in miR-122 is correlated with liver metastasis.
  • the method further comprises the detection of one or more microRNAs selected from miR-199b-5p, miR-484, miR-490-3p, miR- 520e, miR-337-5p, miR-485-39, miR-145, miR-144, miR-216a, miR-92b, miR-365, miR-708 or miR-143, wherein a decrease in expression is correlated with liver metastasis from a primary colorectal tumor.
  • the method further comprises the steps of treating the colorectal cancer with a therapeutic agent, obtaining one or more patient samples and determining if there has been a change in the expression of the one or more microRNAs, wherein a change in expression is indicative of colorectal cancer metastasis.
  • biomarker for detecting colorectal cancer metastasis in a human subject comprising: a biomarker to determine a methylation level of an Alu repeat, wherein a lower methylation level of the Alu repeat is indicative of colorectal cancer and colorectal cancer metastasis in the human subject.
  • the biomarker further comprises at least one first marker selected from let-7i, miR-lOb, miR-200b, miR-320a, and miR-518d and at least one second marker selected from miR-141, miR-200c, and miR-203.
  • kits for determining colorectal cancer metastasis in a human subject comprising: a biomarker detecting reagent for measuring an Alu repeat methylation level in a sample obtained from the human subject; and instructions for the use of the biomarker detecting reagent in diagnosing the presence of colorectal cancer metastasis, wherein the instructions comprise providing step-by-step directions to compare the Alu repeat methylation level in the sample with an Alu repeat methylation level from normal colorectal tissue, wherein a decrease in Alu repeat methylation is indicative of colorectal cancer and colorectal cancer metastasis.
  • the sample is selected from the group consisting of a tissue sample, a fecal sample, a plasma sample, a cell homogenate, a blood sample, one or more biological fluids, or any combinations thereof.
  • the Alu repeat methylation level is determined by measuring the expression status of miR-520c and miR-373 in the biological sample when compared to a normal non-cancerous sample from the human subject.
  • the metastatic cancer is a liver metastasis of a colorectal cancer.
  • the kit further comprises reagents to determine the level of expression of at least one first marker selected from let-7i, miR-lOb, miR-200b, miR-320a, and miR-518d and at least one second marker selected from miR-141, miR-200c, and miR-203.
  • Yet another embodiment of the present invention includes a method for selecting a cancer therapy for a suspect diagnosed with colorectal cancer metastasis, the method comprising the steps of: determining a methylation level of an Alu repeat in a biological sample suspected of being a colorectal cancer metastasis, wherein a decrease in the methylation level of the Alu repeat as compared to a non-cancerous colorectal tissue is indicative of colorectal cancer and colorectal cancer metastasis; and selecting the cancer therapy based on the determination of the presence of colorectal cancer metastasis in the subject.
  • Another embodiment of the present invention includes a method of performing a clinical trial to evaluate a candidate drug believed to be useful in treating colorectal cancer metastasis, the method comprising: (a) determining the presence of colorectal cancer metastasis by a method comprising the steps of: determining an overall Alu repeat methylation level in one or more cells obtained from a biological sample of the subject, wherein a lower overall Alu repeat methylation level compared to a reference control is indicative of colorectal cancer and colorectal cancer metastasis; (b) administering a candidate drug to a first subset of the patients, and a placebo to a second subset of the patients; a comparable drug to a second subset of the patients; or a drug combination of the candidate drug and another active agent to a second subset of patients; (c) repeating step (a) after the administration of the candidate drug or the placebo, the comparable drug or the drug combination; and (d) monitoring a change in the overall Alu repeat methylation level as compared to
  • the present invention includes a method of performing a clinical trial to evaluate a candidate drug believed to be useful in treating colorectal cancer metastasis, the method comprising: (a) determining a level of expression of at least one of let-7i, miR-lOb, miR-320a, or miR-221 in the sample from the one or more biological samples in one or more cells obtained from a biological sample of the subject, wherein a lower overall expression level of the first marker and a higher expression level in the second marker, when compared to a reference control, is indicative of colorectal cancer metastasis; (b) administering a candidate drug to a first subset of the patients, and a placebo to a second subset of the patients; a comparable drug to a second subset of the patients; or a drug combination of the candidate drug and another active agent to a second subset of patients; (c) repeating step (a) after the administration of the candidate drug or the placebo, the comparable drug or the drug combination; and (d) monitoring a
  • Yet another embodiment of the present invention includes a method for detecting colorectal cancer metastasis in a human subject comprising the steps of: identifying the human subject suspected of suffering from a colorectal cancer metastasis; obtaining one or more biological samples suspected of being metastatic from the human subject; determining an Alu repeat methylation level for the one or more biological samples; and comparing the Alu repeat methylation level from the human subject to an Alu repeat methylation level from normal colorectal tissue, wherein a lower degree of methylation in the Alu repeat level from the human subject is indicative of colorectal cancer and colorectal cancer metastasis.
  • the biological samples are selected from the group consisting of a tissue sample, a plasma sample, a fecal sample, a cell homogenate, a blood sample, one or more biological fluids, or any combinations thereof.
  • the Alu repeat methylation level is determined by quantitative bisulfite pyrosequencing, thin layer chromatography (TLC), high performance liquid chromatography (HPLC), mass spectrometry (MS), nanopore amperometry, nanopore sequencing, single-molecule, real-time (SM-RT) sequencing, endonuclease digestion, microarrays, matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry, and next-generation sequencing.
  • the Alu repeat methylation level is determined by measuring the expression status of miR-520c and miR-373 in the biological sample when compared to a normal non-cancerous sample from the human subject.
  • the metastatic cancer is a liver metastasis of a colorectal cancer.
  • the method further comprises the steps of: determining an expression level for the one or more biological samples for at least one first marker selected from let-7i, miR-lOb, miR-200b, miR-320a, and miR-518d and at least one second marker selected from miR-141, miR-200c, and miR-203; and comparing the expression levels of the markers to a colorectal sample that is normal control level, wherein a decrease in the level of expression of the at least one first marker and an increase in the level of expression of the second marker is also indicative of colorectal cancer metastasis.
  • Another embodiment of the present invention includes a method for diagnosis, prediction, or prognosis of colorectal cancer in a human subject comprising the steps of: obtaining one or more biological samples from the human subject; determining a level of expression of let-7i, miR-lOb, miR-320a, and miR-221 in the sample from the one or more biological samples; and comparing the level of expression of let-7i, miR-lOb, miR-320a, and miR-221 in the sample with the level of expression of let-7i, miR-lOb, miR-320a, and miR-221 from normal colorectal tissue, wherein high expression of at least on of let-7i or miR-320a is indicative of a good prognosis for the colorectal cancer, while the low expression of at least one of miR-lOb or miR-221 is indicative of a good prognosis for the colorectal cancer or colorectal cancer metastasis.
  • the biological samples are selected from the group consisting of a tissue sample, a plasma sample, a fecal sample, a cell homogenate, a blood sample, one or more biological fluids, or any combinations thereof.
  • the level of expression of let-7i, miR-lOb and miR- 320a in primary colorectal cancer is prognostic of distant metastasis.
  • the level of expression of let-7i, miR-lOb correlated with the TNM colorectal cancer stage.
  • a high level of expression of let-7i indicates a good prognosis for colorectal cancer survival.
  • a low level of expression of let-7i indicates a poor prognosis for colorectal cancer survival.
  • a high level of expression of at least one of let-7i or miR-320a is predictive of less cancer metastasis.
  • a low level of expression of at least one of miR-lOb or miR-221 is predictive of less cancer metastasis.
  • the metastatic cancer is a liver metastasis of a colorectal cancer.
  • the level of expression is determined by digital color-coded barcode technology analysis, microarray expression profiling, PCR, reverse transcriptase PCR, reverse transcriptase real-time PCR, quantitative real-time PCR, end-point PCR, multiplex end-point PCR, cold PCR, ice-cold PCR, mass spectrometry, or nucleic acid sequencing.
  • the method further comprises the detection of miR-122, wherein an increase in miR-122 is correlated with liver metastasis.
  • the method further comprises the detection of one or more microRNAs selected from miR-199b-5p, miR-484, miR-490-3p, miR-520e, miR-337-5p, miR-485-39, miR-145, miR-144, miR-216a, miR-92b, miR-365, miR-708 or miR-143, wherein a decrease in expression is correlated with liver metastasis from a primary colorectal tumor.
  • microRNAs selected from miR-199b-5p, miR-484, miR-490-3p, miR-520e, miR-337-5p, miR-485-39, miR-145, miR-144, miR-216a, miR-92b, miR-365, miR-708 or miR-143, wherein a decrease in expression is correlated with liver metastasis from a primary colorectal tumor.
  • Yet another embodiment of the present invention includes a method for diagnosing or detecting colorectal cancer metastasis in a human subject comprising the steps of: obtaining one or more biological samples from the human subject suspected of comprising a metastatic cancer; determining an expression level for the one or more biological samples for at least one first marker selected from let-7i, miR-lOb, miR-200b, miR-320a, and miR-518d and at least one second marker selected from miR-141, miR-200c, and miR-203; and comparing the expression levels of the markers to a colorectal sample that is normal control level, wherein a decrease in the level of expression of the at least one first marker and an increase in the level of expression of the second marker is indicative of colorectal cancer metastasis.
  • the biological samples are selected from the group consisting of a tissue sample, a plasma sample, a fecal sample, a cell homogenate, a blood sample, one or more biological fluids, or any combinations thereof.
  • the expression level of 2, 3, 4, or 5 of the first marker microRNAs are downregulated.
  • the expression level of 2 or 3 of the second marker microRNAs are upregulated.
  • the expression level of the first and second markers is measured by microarray expression profiling, PCR, reverse transcriptase PCR, reverse transcriptase real-time PCR, quantitative real-time PCR, end-point PCR, multiplex end- point PCR, cold PCR, ice-cold PCR, mass spectrometry, or nucleic acid sequencing.
  • the metastatic cancer is a liver metastasis of a colorectal cancer.
  • the method further comprises the step of determining an Alu repeat methylation level for the one or more biological samples; and comparing the Alu repeat methylation level to an Alu repeat methylation level from normal colorectal tissue, wherein a decrease in the Alu repeat methylation level is also indicative of colorectal cancer and colorectal cancer metastasis.
  • Yet another embodiment of the present invention also includes a biomarker for colorectal metastasis that comprises at least one first marker selected from microRNAs: let-7i, miR-lOb, miR-200b, miR-320a, and miR-518d; and at least one second marker selected from microRNAs: miR-141, miR-200c, and miR-203, wherein a change in the overall expression of the one or more first and the second marker a sample obtained from a patient is indicative of colorectal metastasis when compared to the overall expression of the first and second marker expression in normal colorectal neoplasia cells or colorectal neoplasia cells obtained at an earlier timepoint from the same patient.
  • a biomarker for colorectal metastasis that comprises at least one first marker selected from microRNAs: let-7i, miR-lOb, miR-200b, miR-320a, and miR-518d; and at least one second marker selected from microRNA
  • the first markers are underexpressed in metastatic cancer and are selected from 2, 3, 4, or 5 of the microRNAs.
  • 2 or 3 of the second marker microRNAs are overexpressed in metastatic cancer.
  • the biomarker further comprises an Alu repeat methylation level of the sample and an Alu repeat methylation control level, wherein a lower degree of the Alu repeat methylation level is also indicative of colorectal cancer and colorectal cancer metastasis.
  • kits for determining colorectal cancer metastasis in a human subject comprising: a biomarker detecting reagent for measuring at least one first marker selected from microRNAs: let-7i, miR-lOb, miR-200b, miR-320a, and miR- 518d; and at least one second marker selected from microRNAs: miR-141, miR-200c, and miR- 203 level in a sample; and instructions for the use of the biomarker detecting reagent in diagnosing the presence of colorectal cancer metastasis, wherein the instructions comprise providing step-by-step directions to compare the expression level for the first and second markers in the sample with a normal colorectal tissue which comprises a control level.
  • the sample is selected from the group consisting of a tissue sample, a fecal sample, a plasma sample, a cell homogenate, a blood sample, one or more biological fluids, or any combinations thereof.
  • the normal colorectal tissue control level is obtained from a biological sample obtained from a healthy subject, wherein the healthy subject is a human subject not suffering from cancer metastasis or non-cancerous tissue from the same patient.
  • the kit further comprises an Alu repeat methylation detecting reagent to determine the Alu repeat methylation level of the sample and an Alu repeat methylation control level, wherein a lower degree of the Alu repeat methylation level is also indicative of colorectal cancer and colorectal cancer metastasis.
  • the metastatic cancer is a liver metastasis of a colorectal cancer.
  • Another embodiment of the present invention includes a method of performing a clinical trial to evaluate a candidate drug believed to be useful in treating colorectal cancer metastasis, the method comprising: (a) determining the presence of colorectal cancer metastasis by a method comprising the steps of: determining an overall level of expression of at least one first marker selected from microRNAs: let-7i, miR-lOb, miR-200b, miR-320a, and miR-518d; and at least one second marker selected from microRNAs: miR-141, miR-200c, and miR-203 in one or more cells obtained from a biological sample of the subject, wherein a lower overall expression level of the first marker and a higher expression level in the second marker, when compared to a reference control, is indicative of colorectal cancer metastasis; (b) administering a candidate drug to a first subset of the patients, and a placebo to a second subset of the patients; a comparable drug to a second subset of the patients;
  • Yet another embodiment of the present invention includes a method for detecting colorectal cancer metastasis in a human subject comprising the steps of: identifying the human subject suspected of suffering from a colorectal cancer; obtaining one or more biological samples from the human subject; determining the level of expression of at least one first marker selected from microRNAs: let-7i, miR-lOb, miR-200b, miR-320a, and miR-518d; and at least one second marker selected from microRNAs: miR-141, miR-200c, and miR-203 for the one or more biological samples; and comparing the expression level of the first and second markers to the expression level of the first and second markers in normal tissues, wherein a decrease in the expression level of the first marker and an increase in the expression level of the second marker as compared to normal tissue is indicative of colorectal cancer metastasis.
  • the biological samples are selected from the group consisting of a tissue sample, a plasma sample, a fecal sample, a cell homogenate, a blood sample, one or more biological fluids, or any combinations thereof.
  • the expression level of 2, 3, 4, or 5 of the first marker microRNAs are downregulated.
  • the expression level of 2 or 3 of the second markers microRNAs are upregulated.
  • the expression level of the first and second markers is measured by microarray expression profiling, PCR, reverse transcriptase PCR, reverse transcriptase real-time PCR, quantitative real-time PCR, end-point PCR, multiplex end-point PCR, cold PCR, ice-cold PCR, mass spectrometry, or nucleic acid sequencing.
  • the metastatic cancer is a liver metastasis of a colorectal cancer.
  • the method further comprises the step of determining an Alu repeat methylation level for the one or more biological samples; and comparing the Alu repeat methylation level to an Alu repeat methylation control level, wherein a lower degree of the Alu repeat methylation level is also indicative of colorectal cancer and colorectal cancer metastasis.
  • Yet another embodiment of the present invetion includes a method of diagnosing or providing a prognosis for colorectal cancer metastasis, the method comprising the steps of: obtaining a biological sample from a human subject suspected of or having colorectal cancer metastasis; detecting in the biological sample altered expression for an Alu repeat methylation level for the one or more biological samples, wherein a decrease in the Alu repeat methylation level is indicative of at least one of colorectal cancer disease progression or colorectal cancer metastasis; and providing a diagnosis or prognosis for colorectal cancer metastasis.
  • Another embodiment includes a method of diagnosing or providing a prognosis for colorectal cancer metastasis, the method comprising the steps of: obtaining a biological sample from a human subject suspected of or having colorectal cancer metastasis; detecting in the biological sample altered expression (over or under expression of at least 50% compared to a subject without colorectal cancer metastasis) of let-7i, miR-lOb, miR-320a, and miR-221, wherein high expression of at least one of let-7i or miR-320a is indicative of a good prognosis for the colorectal cancer, while the low expression of at least one of miR-lOb or miR-221 is indicative of a good prognosis for the colorectal cancer or colorectal cancer metastasis; and providing a diagnosis or prognosis for colorectal cancer metastasis.
  • Figure 1 shows the expression analysis of metastasis predictive microRNAs expression comparing Primary Colorectal (PC) cancer microRNA expression compared to colorectal cancer (CRC) liver metastasis (LM) microRNA expression.
  • PC Primary Colorectal
  • CRC colorectal cancer
  • LM liver metastasis
  • Figure 2 is an analysis of the expression of the miR-200 family (-200b, -200c, -141 and -429), and miR-203 in serum samples from CRC patients with metastasis (Stage IV) and without metastasis (Stage I) by qRT-PCR.
  • the expression of mir-200c and miR-203 were significantly elevated in serum samples from CRC patients with metastasis (Stage IV) compared to patients without metastasis (Stage I).
  • Figure 3 shows the role of Alu methylation as a surrogate marker for global methylation
  • CRC cell lines were treated with the demethylating agent (5-azacytidine), which were used to confirm methylation status of global Alu repetitive element by quantitative pyrosequencing for each of the listed CRC cell lines.
  • Figure 4 is an analysis of the global Alu methylation status in matched corresponding primary CRC (PC) and liver metastasized CRC (LM) human tissues by pyrosequencing.
  • Figure 5A are maps that show the Alu hypomethylation regulated the expression of down- stream miR-373, but not miR-520c.
  • Figure 5B shows that Alu methylation inversely correlated with miR-373 expression in CRC cell lines.
  • Figure 5C shows that Alu methylation did not correlate with miR-520c expression in CRC cell lines.
  • Figure 6A is an analysis of the expression of miR-520c. All cell lines showed low level of miR- 520c expression, except Lovo cell.
  • Figure 6B shows that the expression of miR-520c was induced by a demethylating agent. This data indicates that miR-520c expression is regulated by Alu methylation in promoter region.
  • Figure 7 is an analysis of the expression status all 4 miRNAs that are located downstream of Alu repetitive sequences in matched corresponding primary CRC (PC) and liver metastasized CRC (LM) human tissues by qRT-PCR.
  • LM showed significantly lower expression of miR-30b, miR- 518d, and miR-520c compared to PC.
  • Figure 8A shows that Alu hypomethylation positively correlated with miR-373 expression in LM.
  • Figure 8B shows that Alu hypomethylation did not correlate with miR-520c expression in LM.
  • Figure 9 shows that an RNA pol II inhibitor did not suppress activation of miR-373, but inhibited the expression of miR-520c.
  • Figure 10 shows the results of the qRT-PCR validation for selected miRNAs in 58 PCs and LMs.
  • Figure 11 shows the results from the microarray validation for selected miRNAs in 84 PCs.
  • Figure 12 shows the results of qRT-PCR validation for miR-7i (left graph) and miR-lOb (right graph) in 175 PCs.
  • Figure 13 shows the ISH validation for the expression of miR-7i and miR-lOb in CRC tissues and liver metastasis.
  • the present invention includes biomarkers and methods for detecting Colorectal Cancer (CRC) metastasis and exploring curative target of metastasized CRC, including but not limited to cancer research, cancer screening, diagnosis of metastasis, planning of cancer treatment and molecular target of anti-cancer drug.
  • CRC Colorectal Cancer
  • colonal cancer includes the well-accepted medical definition that defines colorectal cancer as a medical condition characterized by cancer of cells of the intestinal tract below the small intestine (i.e., the large intestine (colon), including the cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum). Additionally, as used herein, the term “colorectal cancer” also further includes medical conditions, which are characterized by cancer of cells of the duodenum and small intestine (jejunum and ileum).
  • tissue sample includes any material composed of one or more cells, either individual or in complex with any matrix obtained from a patient.
  • the definition includes any biological or organic material and any cellular subportion, product or by-product thereof.
  • the definition of "tissue sample” should be understood to include without limitation colorectal tissue samples, tissues suspected of including colorectal cancer cells, blood components, and even fecal matter or fluids that includes colorectal cells.
  • tissue for purposes of this invention are certain defined acellular structures such as dermal layers of epithelium that have a cellular origin but are no longer characterized as cellular.
  • tools or "feces” as used herein is a clinical term that refers to feces obtained from a mammal such as a human.
  • biological fluid refers to a fluid containing cells and compounds of biological origin, and may include blood, stool or feces, lymph, urine, serum, pus, saliva, seminal fluid, tears, urine, bladder washings, colon washings, sputum or fluids from the respiratory, alimentary, circulatory, or other body systems.
  • biological fluids the nucleic acids containing the biomarkers may be present in a circulating cell or may be present in cell-free circulating DNA or R A.
  • gene refers to a functional protein, polypeptide or peptide-encoding unit.
  • this functional term includes both genomic sequences, cDNA sequences, or fragments or combinations thereof, as well as gene products, including those that may have been altered by the hand of man.
  • Purified genes, nucleic acids, protein and the like are used to refer to these entities when identified and separated from at least one contaminating nucleic acid or protein with which it is ordinarily associated.
  • the term “allele” or “allelic form” refers to an alternative version of a gene encoding the same functional protein but containing differences in nucleotide sequence relative to another version of the same gene.
  • nucleic acid or “nucleic acid molecule” refers to polynucleotides, such as deoxyribonucleic acid (DNA) or ribonucleic acid (RNA), oligonucleotides, fragments generated by the polymerase chain reaction (PCR), and fragments generated by any of ligation, scission, endonuclease action, and exonuclease action.
  • Nucleic acid molecules can be composed of monomers that are naturally-occurring nucleotides (such as DNA and RNA), or analogs of naturally-occurring nucleotides (e.g., a-enantiomeric forms of naturally-occurring nucleotides), or a combination of both.
  • Modified nucleotides can have alterations in sugar moieties and/or in pyrimidine or purine base moieties.
  • Sugar modifications include, for example, replacement of one or more hydroxyl groups with halogens, alkyl groups, amines, and azido groups, or sugars can be functionalized as ethers or esters.
  • the entire sugar moiety can be replaced with sterically and electronically similar structures, such as aza-sugars and carbocyclic sugar analogs.
  • modifications in a base moiety include alkylated purines and pyrimidines, acylated purines or pyrimidines, or other well-known heterocyclic substitutes.
  • Nucleic acid monomers can be linked by phosphodiester bonds or analogs of such linkages.
  • nucleic acid molecule also includes so-called “peptide nucleic acids,” which comprise naturally-occurring or modified nucleic acid bases attached to a polyamide backbone. Nucleic acids can be either single stranded or double stranded.
  • a “biomarker” refers to a molecular indicator that is associated with a particular pathological or physiological state.
  • the "biomarker” as used herein is a molecular indicator for cancer, more specifically an indicator for primary CRCs and distant metastasis of primary CRCs.
  • Examples of “biomarkers” include let-7i, miR-lOb, miR-30b, miR-34a, miR-141, miR- 200b, miR-200c, miR-203, miR-221, miR-320a, miR-373, miR-429, miR-518d, and miR-520c.
  • the term "statistically significant” refers to differences between the groups studied, relates to condition when using the appropriate statistical analysis (e.g. Chi-square test, t-test) the probability of the groups being the same is less than 5%, e.g. p ⁇ 0.05. In other words, the probability of obtaining the same results on a completely random basis is less than 5 out of 100 attempts.
  • the level of mir-148a expression was determined by normalizing the expression to, e.g., miR-16, thus, the number 0.069-fold is not a definitive number.
  • kit denotes combinations of reagents and adjuvants required for an analysis.
  • test kit consists in most cases of several units, one-piece analysis elements are also available, which must likewise be regarded as testing kits.
  • TNM refers to the internationally recognized TNM classification of malignant tumors developed and maintained by the International Union against Cancer, which has been adopted by the American Joint Committee on Cancer (AJCC) and the International Federation of Gynecology and Obstetrics (FIGO).
  • AJCC American Joint Committee on Cancer
  • FIGO International Federation of Gynecology and Obstetrics
  • the present invention includes the identification and use of miRNA biomarkers (let-7i, miR-lOb, miR-30b, miR-34a, miR-141, miR-200b, miR-200c, miR-203, miR-221, miR-320a, miR-373, miR-429, miR-518d, and miR-520c) that have been found to be very specific for detecting liver metastasized CRC.
  • miRNA biomarkers let-7i, miR-lOb, miR-30b, miR-34a, miR-141, miR-200b, miR-200c, miR-203, miR-221, miR-320a, miR-373, miR-429, miR-518d, and miR-520c
  • biomarkers were validated using tissue sample miRNAs expression, but also using serum samples of CRC patients with distant metastasis. Furthermore, it was found that Alu repetitive element was hypomethylated in distant metastasized tissues compared to primary CRC, which can regulate the expression of some of the miRNA biomarkers (miR-30b, miR-373, miR-518d, and miR-520c) of the present invention. DNA modification is biologically and chemically stable than RNA transcription. Thus, the miRNA biomarkers of the present invention are more accurate and specific compared to biomarkers developed using just primary cancer tissues.
  • the present invention has several advantages when compared to existing miRNA biomarkers.
  • the miRNAs biomarkers of the present invention are metastasis specific biomarkers because they are derived from the direct comparison between primary CRC and matching liver metastasis tissues.
  • the miRNAs biomarkers of the present invention are more specific for the detection of CRC metastasis, as validated using miRNAs expression of serum samples from CRC patients with and without distant metastasis.
  • the miRNAs biomarkers of the present invention can be applied to detect any diseases which related with global hypomethylation, as it was also found that hypomethylation (decrease of methylation) of Alu repetitive sequence in distant metastasis tissue compared to primary CRC tissue, which can regulate Alu sequence downstream located miRNAs expression (miR-30b, miR-373, miR-518d, and miR-520c).
  • MicroRNA expression levels were determined by quantitative real-time PCR (qRT-PCR) and the data were normalized relative to miR-16 expression. Second, we have also investigated global Alu methylation and local Alu methylation status by quantitative pyrosequencing analysis in matched primary colorectal cancer and corresponding liver metastasis tissues.
  • TLC thin layer chromatography
  • HPLC high performance liquid chromatography
  • MS mass spectrometry
  • nanopore amperometry nanopore sequencing
  • SM-RT real-time sequencing
  • MALDI-TOF matrix-assisted laser desorption ionization time-of-flight
  • the present invention may include the use of digital color-coded barcode technology analysis (e.g., NANOSTRTNG® technology (such as the nCounter Analysis System, NanoString Technologies, Inc., Seattle, Washington).
  • NANOSTRTNG®protocol includes the following steps: (1) Hybridization: two ⁇ 50 base probes per mRNA that hybridize in solution, a reporter probe that carries the signal, while a capture probe allows the complex to be immobilized for data collection.
  • CRC cell lines and 5-aza-2-deoxy-cytidine treatment Seven CRC cell lines, HCT1 16, RKO, SW48, Caco-2, HT29, SW480, and SW620 were obtained from the American Type Culture Collection (ATCC, Rockville, MD). Cell lines were treated with 2.5 ⁇ 5-Aza-2 ' -deoxycytidine (5-aza-dC; Sigma-Aldrich) for 72 hours, and fresh medium containing 5-aza-dC was replaced every 24 hours.
  • 5-aza-2 ' -deoxycytidine 5-aza-dC; Sigma-Aldrich
  • FFPE formalin- fixed, paraffin-embedded
  • NM normal cololectal mucosa
  • PC primary CRC tissues
  • LM liver metastasis tissues
  • RNA and DNA Isolation of RNA and DNA.
  • Total RNA (including miRNAs) from CRC cell lines was extracted using miRNeasy® Mini Kits (Qiagen).
  • miRNeasy® Mini Kits Qiagen
  • a Total Nucleic Acid Isolation Kit for FFPE tissues was used according to the manufacturer's instructions.
  • DNA was extracted from CRC cell lines using a QIAamp® DNA Mini Kit (Qiagen) and from FFPE specimens using a QIAamp® DNA FFPE Tissue Kit (Qiagen).
  • miRNA expression analysis Analysis of fourteen metastasis-related miRNAs (let-7i, miR- 10b, miR-30b, miR-34a, miR-141, miR-200b, miR-200c, miR-203, miR-221, miR-320a, miR- 373, miR-429, miR-518d, and miR-520c) was analyzed using TaqMan miRNA assays (Applied Biosystems Inc., Foster City, CA). Expression of RNU6B (Applied Biosystems Inc., Foster City, CA) and miR-16 were used as endogenous controls for cell lines and FFPE tissues, respectively.
  • Methylation levels of repetitive sequences were analyzed by quantitative bisulfite pyrosequencing using the PSQ HS 96A pyrosequencing system (Qiagen) following bisulfite modification of genomic DNA using EZ DNA methylation Gold Kits (Zymo Research), as described previously.
  • CRC Cell line CAC02, HCT1 16, RKO, SW48, SW480, and SW620.
  • Tissue specimens A total of 59 formalin- fixed, paraffin-embedded (FFPE) primary CRC tissues and corresponding liver metastasis tissues were analyzed.
  • FFPE paraffin-embedded
  • 5-Aza-2 ' -deoxycytidine (5-aza-dC) treatment CRC cell lines were treated with 2.5 ⁇ 5-aza-dC for 72 hours
  • a- amanitin treatment CRC cell lines were treated with 50 ⁇ g/ml a-amanitin, a RNA pol II inhibitor, for 7 hours.
  • Methylation analysis Methylation levels were analyzed by bisulfite pyrosequencing for quantitative methylation analysis using PSQ HS 96A pyrosequencing system (Qiagen) on bisulfite modified genomic DNA template.
  • microRNAs expression analysis Expression of miR-373 and miR-520c was analyzed using TaqMan miRNA assays.
  • Figure 1 shows a metastasis predictive microRNAs expression colorectal cancer (CRC).
  • CRC metastasis predictive microRNAs expression colorectal cancer
  • Figure 2 is an analysis of the expression of the miR-200 family (-200b, -200c, -141 and -429), and miR-203 in serum samples from CRC patients with metastasis (Stage IV) and without metastasis (Stage I) by qRT-PCR.
  • the expression of mir-200c and miR-203 were significantly elevated in serum samples from CRC patients with metastasis (Stage IV) compared to patients without metastasis (Stage I).
  • Figure 3 shows the percent methylation the role of Alu methylation as a surrogate marker for global methylation
  • CRC cell lines were treated with the demethylating agent (5-azacytidine), which were used to confirm methylation status of global Alu repetitive element. Briefly, quantitative pyrosequencing was performed in CRC cell lines. All MSI and MSS CRC cell lines showed hypomethylation of Alu element. The Alu element was markedly demethylated by 5- aza treatment indicating Alu methylation can be used as a global DNA methylation indicator.
  • Figure 4 is an analysis of the global Alu methylation status in matched corresponding primary CRC (PC) and liver metastasized CRC (LM) human tissues by pyrosequencing. LM showed significantly lower Alu methylation compared to PC. This data suggests that Alu hypomethylation is involved in CRC metastasis, which indicates usefulness of Alu methylation as a marker of CRC metastasis.
  • the present inventors analyzed the location of the various miRNAs using the UCSC Genome Browser. Briefly, the miRNA sequences were found in the context of the genome in which they are located and it was found that miR-30b, miR-373, miR- 518d, and miR-520c are located downstream of Alu elements (data not shown).
  • Figure 5 A are maps that show the Alu hypomethylation regulated the expression of downstream miR-373, but not miR-520c.
  • Figure 5B shows that Alu methylation inversely correlated with miR-373 expression in CRC cell lines.
  • FIG. 5C shows that Alu methylation did not correlate with miR-520c expression in CRC cell lines.
  • the expression of miR-373 was induced by demethylating agent, and Alu element in miR-373 promoter region was demethylated by 5Aza treatment. These data indicate that miR- 373 expression is regulated by Alu methylation.
  • Figure 6A is an analysis of the expression of miR-520c, which is located in Alu element downstream. All cell lines showed low level of miR-520c expression, except Lovo cell.
  • FIG. 6B shows that the expression of miR-520c was induced by a demethylating agent.
  • This data indicates that miR-520c expression is regulated by Alu methylation in promoter region.
  • Figure 7 is an analysis of the expression status all 4 miRNAs that are located downstream of Alu repetitive sequences in matched corresponding primary CRC (PC) and liver metastasized CRC (LM) human tissues by qRT-PCR.
  • LM showed significantly lower expression of miR-30b, miR- 518d, and miR-520c compared to PC.
  • miR-373 was significantly up- regulated in LM compared to PC. This data shows that the expression of these four miRNAs distinguished between PC and LM.
  • the expression of these four miRNAs expression was regulated by Alu elements methylation, which are located in promoter region.
  • Figure 8A shows that Alu hypomethylation positively correlated with miR-373 expression in LM.
  • Figure 8B shows that Alu hypomethylation did not correlate with miR-520c expression in LM.
  • Figure 9 shows that an RNA pol II inhibitor did not suppress activation of miR-373, but inhibited the expression of miR-520c.
  • miRNA signature can be used to distinguish between primary CRC and liver metastasis. It was found that a subset of miRNAs, including: let-7i, miR-lOb, miR-30b, miR-200b, miR-320a, and miR-518d were significantly downregulated in liver metastasis tissues compared to primary CRC. In contrast, miRNAs such as miR-141, miR-200c, and miR-203 were significantly over-expressed in liver metastasis tissues. In a further evaluation step using serum samples from CRC patients, it was found that the serum expression levels of miR-200c and miR-203 were upregulated in CRC patients with distant metastasis compared to CRC patients without metastasis.
  • the methylation status of Alu elements was determined by quantitative bisulfite pyrosequencing, and the expression of miRNAs (miR-30b, miR-373 and miR-520c) was measured by quantitative real-time PCR.
  • Global hypomethylation of Alu sequences was observed by treatment of the DNA demethylating agent, 5-azacytidine, in the CRC cell lines.
  • methylation analysis of surrounding normal liver tissues revealed higher levels of Alu methylation (mean methylation value; 85%) when compared to both PC and LM.
  • the expression of miRNAs located downstream from Alu regions. For example, it was found that miR- 373 expression was significantly increased in liver metastasis compared to matching primary CRC clinical samples. In contrast, expression of miR-30b and miR-520c was significantly decreased in liver metastasis when compared to matching primary CRC tissues.
  • hypomethylation occurs in liver metastasis tissues from patients with CRC.
  • hypomethylation of Alu repeat elements permit activation of metastasis-related miRNAs, which in turn may facilitate a more aggressive malignant phenotype in these advanced stage cancers.
  • the screening step included the following materials: 9 pairs of primary CRC (PC) and matched liver metastasis (LM), Frozen tissue, Not-microdissected, method used: NANOSTRTNG®.
  • the validation step in matched PCs and LMs included the following materials: 58 pairs of PC and matched LM, formalin-fixed, paraffin-embedded (FFPE) tissue, Microdissected.
  • the method for analysis was TaqMan miRNA assays, miR-16 was used as endogenous control.
  • a microarray validation step included the following materials: 84 pairs of PC and corresponding normal mucosa (NM), frozen tissue, not-microdissected.
  • the method used was MicroRNA microarray (quadruplicates of 389 human miRNAs) as published in JAMA. 2008 Jan 30;299(4):425-36.
  • a qRT-PCR Validation step included the following materials: 175 PCs, FFPE tissue, microdissected.
  • the method for analysis was TaqMan miRNA assays, with miR-16 used as endogenous control.
  • Table 1 is a summary of the clinicopathology characteristics of the colorectal cancer patients.
  • Table 2 Shows the 19 miRNAs differentially expressed in matched PCs and LMs using the NANOSTRING®screening step.
  • Figure 10 shows the Results - qRT-PCR validation for selected miRNAs in 58 PCs and LMs.
  • Figure 1 1 shows the results from the microarray validation for selected miRNAs in 84 PCs (Kaplan-Meier survival curves), in which high expression of has-let-7i and has-miR-320a indicated a good prognosis, which a low expression of has-miR-lOb and has-miR-221 indicated a good prognosis.
  • Table 3 shows the results from the microarray validation for 4 miRNAs in 84 PCs, briefly, it was found that The expression of let-7i, miR-lOb and miR-320a in PC was significantly associated with the distant metastasis, while the expression of let-7i and miR-lOb was significantly associated with the TNM stage.
  • Table 4 shows the results of microarray validation for 4 miRNAs in 84 PCs, using a Cox proportional hazards model. It was found that low expression of let-7i was an independent prognostic factor.
  • Table 5 shows the results of microarray validation for 4 miRNAs in 84 PCs, using a logistic regression model. It was found that all 4 miRNAs (let-7i, miR-320a, miR-lOb and miR-221) expression in PCs was significantly associated with the distant metastasis. It was also found that low expression of let-7i and high expression of miR-lOb in PCs were an independent metastasis prediction marker, respectively.
  • Figure 12 shows the results of qRT-PCR validation for miR-7i and miR-lOb in 175 PCs. Survival analysis of 2 microarray validated miRNAs is shown.
  • Table 6 shows the results of qRT-PCR validation for miR-7i and miR-lOb in 175 PCs. It was found that the expression of let-7i, miR-lOb and miR-320a in PC was significantly associated with the distant metastasis (using the Kreskal- Wallis test). The expression of let-7i and miR-lOb was significantly associated with the TNM stage.
  • Table 7 shows the results from qRT-PCR validation for miR-7i and miR-lOb in 175 PCs using the Cox proportional hazards model. It was found that Low expression of let-7i was significantly associated with CRC patient's prognosis, which was an independent prognostic factor.
  • Table 8 shows the results from qRT-PCR validation for miR-7i and miR-lOb in 175 PCs using a logistic regression model. It was found that expression of let-7i and miR-lOb in PCs was significantly associated with the distant metastasis. Low expression of let-7i and high expression of miR-lOb in PCs were an independent metastasis prediction marker, respectively.
  • Figure 13 shows the ISH validation for the expression of miR-7i and miR-lOb in CRC tissues and liver metastasis.
  • compositions of the invention can be used to achieve methods of the invention.
  • the words “comprising” (and any form of comprising, such as “comprise” and “comprises”), “having” (and any form of having, such as “have” and “has”), “including” (and any form of including, such as “includes” and “include”) or “containing” (and any form of containing, such as “contains” and “contain”) are inclusive or open-ended and do not exclude additional, unrecited elements or method steps.
  • A, B, C, or combinations thereof refers to all permutations and combinations of the listed items preceding the term.
  • A, B, C, or combinations thereof is intended to include at least one of: A, B, C, AB, AC, BC, or ABC, and if order is important in a particular context, also BA, CA, CB, CBA, BCA, ACB, BAC, or CAB.
  • expressly included are combinations that contain repeats of one or more item or term, such as BB, AAA, MB, BBC, AAABCCCC, CBBAAA, CABABB, and so forth.
  • the skilled artisan will understand that typically there is no limit on the number of items or terms in any combination, unless otherwise apparent from the context.
  • words of approximation such as, without limitation, "about”, “substantial” or “substantially” refers to a condition that when so modified is understood to not necessarily be absolute or perfect but would be considered close enough to those of ordinary skill in the art to warrant designating the condition as being present.
  • the extent to which the description may vary will depend on how great a change can be instituted and still have one of ordinary skilled in the art recognize the modified feature as still having the required characteristics and capabilities of the unmodified feature.
  • a numerical value herein that is modified by a word of approximation such as "about” may vary from the stated value by at least ⁇ 1, 2, 3, 4, 5, 6, 7, 10, 12 or 15%.
  • compositions and/or methods disclosed and claimed herein can be made and executed without undue experimentation in light of the present disclosure. While the compositions and methods of this invention have been described in terms of preferred embodiments, it will be apparent to those of skill in the art that variations may be applied to the compositions and/or methods and in the steps or in the sequence of steps of the method described herein without departing from the concept, spirit and scope of the invention. All such similar substitutes and modifications apparent to those skilled in the art are deemed to be within the spirit, scope and concept of the invention as defined by the appended claims.

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Abstract

La présente invention concerne des procédés et des biomarqueurs destinés au diagnostic ou à la détection de métastases du cancer colorectal chez un sujet humain en comparant le niveau de méthylation de la répétition Alu dans un échantillon biologique à un niveau témoin de méthylation de la répétition Alu provenant d'un échantillon normal non cancéreux d'un sujet humain, une diminution du niveau de méthylation de la répétition Alu étant indicatrice de cancer colorectal et de métastases du cancer colorectal. L'invention inclut également des procédés et des biomarqueurs destinés au diagnostic ou à la détection de métastases du cancer colorectal (CCR) chez un sujet humain par la détermination d'un niveau d'expression de let-7i, miR-10b, miR-320a et miR-221 dans l'échantillon provenant d'un ou de plusieurs échantillons biologiques et par la comparaison du niveau d'expression de let-7i, miR-10b, miR-320a et miR-221 dans l'échantillon au niveau d'expression de let-7i, miR-10b, miR-320a et miR-221 provenant d'un tissu colorectal normal ; l'expression élevée d'au moins un parmi let-7i ou miR-320a est indicatrice d'un bon pronostic concernant le CCR, alors que la faible expression d'au moins un parmi miR-10b ou miR-221 est indicatrice d'un bon pronostic concernant le CCR ou des métastases de CCR.
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