Biomarkers related to FOCM in colorectal cancer recurrence and survival (FOCUS)

Colorectal cancer (CRC) is the second leading cause of cancer death. At the same time, the number of survivors of CRC continues to increase. Many cancer patients resort to taking nutritional supplements, assuming potential benefits. However, in the case of folate this assumption may be wrong, since high folate may stimulate the growth of established cancer. Within a large consortium of parallel European CRC patient cohorts we will be able to investigate, comprehensively, the role of folate from diet and supplements, the impact on a state-of-the art set of one-carbon metabolism biomarkers, and their joint influence on clinical outcomes, including recurrence, survival and treatment toxicity. Our study aims to investigate whether prognosis in stage I-III CRC is related to folate status at different time-intervals- prior to surgery, and at 6 and 12 months past surgery- in 1584 CRC patients. Austria will contribute with 199 CRC patients (I-III) from CORSA (Colorectal Cancer Study of Austria) to this study. Further, we propose to determine whether biomarkers related to folate-mediated one- carbon metabolism (FOCM) are associated with folate intake, and explore whether folate status modifies treatment toxicity in patients who underwent 5-FU chemotherapy. We expect that by unraveling the effect of the folate and FOCM biomarkers on CRC prognosis we will be able to provide clinically relevant advice to cancer patients and define future tertiary prevention strategies. The project coordination (Prof. Gsur is the leading coordinator of this interdisciplinary consortium), data managemet and statistical analysis will take place in Austria.