Association Between Results of a Gene Expression Signature Assay and Recurrence-Free Interval in Patients With Stage II Colon Cancer in Cancer and Leukemia Group B 9581 (Alliance)

PURPOSE: Conventional staging methods are inadequate to identify patients with stage II colon cancer (CC) who are at high risk of recurrence after surgery with curative intent. ColDx is a gene expression, microarray-based assay shown to be independently prognostic for recurrence-free interval (RFI) and overall survival in CC. The objective of this study was to further validate ColDx using formalin-fixed, paraffin-embedded specimens collected as part of the Alliance phase III trial, C9581.

PATIENTS AND METHODS: C9581 evaluated edrecolomab versus observation in patients with stage II CC and reported no survival benefit. Under an initial case-cohort sampling design, a randomly selected subcohort (RS) comprised 514 patients from 901 eligible patients with available tissue. Forty-nine additional patients with recurrence events were included in the analysis. Final analysis comprised 393 patients: 360 RS (58 events) and 33 non-RS events. Risk status was determined for each patient by ColDx. The Self-Prentice method was used to test the association between the resulting ColDx risk score and RFI adjusting for standard prognostic variables.

RESULTS: Fifty-five percent of patients (216 of 393) were classified as high risk. After adjustment for prognostic variables that included mismatch repair (MMR) deficiency, ColDx high-risk patients exhibited significantly worse RFI (multivariable hazard ratio, 2.13; 95% CI, 1.3 to 3.5; P < .01). Age and MMR status were marginally significant. RFI at 5 years for patients classified as high risk was 82% (95% CI, 79% to 85%), compared with 91% (95% CI, 89% to 93%) for patients classified as low risk.

CONCLUSION: ColDx is associated with RFI in the C9581 subsample in the presence of other prognostic factors, including MMR deficiency. ColDx could be incorporated with the traditional clinical markers of risk to refine patient prognosis.

Time-Independent Discrete Gaussian Sampling for Post-Quantum Cryptography

As the development of a viable quantum computer nears, existing widely used public-key cryptosystems, such as RSA, will no longer be secure. Thus, significant effort is being invested into post-quantum cryptography (PQC). Lattice-based cryptography (LBC) is one such promising area of PQC, which offers versatile, efficient, and high performance security services. However, the vulnerabilities of these implementations against side-channel attacks (SCA) remain significantly understudied. Most, if not all, lattice-based cryptosystems require noise samples generated from a discrete Gaussian distribution, and a successful timing analysis attack can render the whole cryptosystem broken, making the discrete Gaussian sampler the most vulnerable module to SCA. This research proposes countermeasures against timing information leakage with FPGA-based designs of the CDT-based discrete Gaussian samplers with constant response time, targeting encryption and signature scheme parameters. The proposed designs are compared against the state-of-the-art and are shown to significantly outperform existing implementations. For encryption, the proposed sampler is 9x faster in comparison to the only other existing time-independent CDT sampler design. For signatures, the first time-independent CDT sampler in hardware is proposed.