{"entity":{"id":"paper-cms-guinney-nat-med-2015","kind":"paper","name":"The consensus molecular subtypes of colorectal cancer","aka":[],"tldr":"An international consortium reconciled six competing gene-expression classifications of colorectal cancer into four consensus subtypes, from immune-active microsatellite-unstable tumours to mesenchymal tumours with the worst outlook.","summary":"Analysis of gene expression data from 4,151 colorectal cancers across 18 datasets by the Colorectal Cancer Subtyping Consortium, producing four consensus molecular subtypes: CMS1 (microsatellite instability, immune), CMS2 (canonical, WNT and MYC), CMS3 (metabolic, KRAS-enriched) and CMS4 (mesenchymal, stromal, worst survival), with about 13 percent of tumours unclassified.","asOf":"2026-09-17","links":[{"label":"Nat Med 2015","url":"https://doi.org/10.1038/nm.3967"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/26457759/"}],"tags":[],"related":[],"cancers":["braf-v600e-colorectal","early-onset-colorectal"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nature-medicine"],"dependsOn":[],"notes":[],"journal":"Nature Medicine","year":2015,"doi":"10.1038/nm.3967","pmid":"26457759","authors":"Guinney J, Dienstmann R, Wang X, et al.","paperType":"translational","findings":["Four subtypes with distinct biology; CMS4 had the worst overall and relapse-free survival, CMS1 the worst survival after relapse."],"whatItMeans":"The CMS framework organises colorectal cancer biology and trial stratification; BRAF V600E tumours cluster in CMS1, and CMS4's poor prognosis and stromal signalling are targets of ongoing research.","caveats":["Transcriptomic classification is not yet used to choose treatment in routine practice.","Intratumoural heterogeneity means single biopsies may misclassify."],"changedPractice":true,"participants":4151},"route":"/key-papers/paper-cms-guinney-nat-med-2015/","neighbours":{"cancer":[{"id":"braf-v600e-colorectal","kind":"cancer","name":"BRAF V600E-mutant colorectal cancer","route":"/cancers/braf-v600e-colorectal/"},{"id":"early-onset-colorectal","kind":"cancer","name":"Early-onset colorectal cancer (under 50)","route":"/cancers/early-onset-colorectal/"}],"journal":[{"id":"nature-medicine","kind":"journal","name":"Nature Medicine","route":"/journals/nature-medicine/"}]}}