Overview

This is a prospective, non-randomized, observational, pre-clinical validation study. Pierian Biosciences is utilizing ChemoINTEL assay measured in vitro cytotoxic drug induced apoptosis and cell death in isolated fresh human tumour cells from patients with colorectal cancer (CRC) to predict a patient's tumour's sensitivity to specific chemotherapy drugs using the ChemoINTEL unified algorithm. Eligible patients will be assigned to one of three groups depending on the stage of disease :

Group 1: Patients who have colorectal cancer and are referred for adjuvant chemotherapy after MDT discussion.

Group 2: Patients with stage II colorectal cancer with high risk features not referred for adjuvant chemotherapy (at risk of relapse) Group 3: Patients with locally advanced rectal cancer who have had a complete response to chemoradiotherapy (research objective).

At least one solid tumour specimen and adjacent normal tissue will be sent to Pierian Biosciences Laboratory in Liverpool, UK along with an optional 10-20ml blood sample and The Pierian Biosciences laboratory staff will conduct the ChemoINTEL and ImmunoINTEL assays blinded to all specimen and clinical information except the tumor type (e.g. Colon Cancer or Rectal Cancer), Specimen ID, and specimen collection date and time. Results of the assay will NOT be shared with clinical sites. Samples from group 3 will be provided if patients undergo surgical resection.

Eligibility

Inclusion Criteria Group 1 Participants:

1. ≥18 years of age
2. Diagnosis of CRC i. Surgical resection followed by adjuvant chemotherapy ii. Biopsy followed by neoadjuvant chemo/radiotherapy and surgical resection.
3. Patients planned to receive at least 6 cycles of standard of care chemotherapy for CRC with single agent or combination of drugs listed in Table 3 following biopsy OR surgical resection
4. One solid tumor specimen is required; a total of two specimens are preferred and requested when available. Specimens will include:
5. Primary solid tumor specimen (≥400 mg) ii. Adjacent normal tissue (\>400mg)
6. Patient signed Informed Consent Form

Exclusion Criteria Group 1 Participants:

1. Patient has not signed an ICF to participate in a clinical investigation
2. Patient has a cancer other than advanced stage CRC
3. Patient is NOT expected to receive SOC chemotherapy, single agents or combination treatment, as listed in Table 3
4. Patients who do not have at sufficient viable cells recovered from fresh tumor dissociation available for the ChemoINTEL assay analysis of Fluorouracil (5-FU), Oxaliplatin, Irinotecan, and Capecitabine