Study Takes Step Towards Personalized Medicine for Colorectal Cancer

Genomic approach increases understanding of cancer.

Taking a genomic approach to treating colorectal cancer may improve patient survival and overall quality of life, a new study published in Nature Communications suggests.

Colorectal cancer is the second leading cause of cancer-related deaths in the United States that affects both men and women, according to the CDC.

“Currently patients with colorectal cancer are offered chemotherapy treatment," said co-senior author Mark Lawler. “While this treatment may be successful for some patients, for others it will have no effect on fighting the cancer, though the patients may suffer debilitating [adverse events] such as nerve damage that can result in a loss of sensation or movement in a part of the body. A ‘one size fits all’ approach isn’t a viable option if we are to effectively tackle this disease.”

In the study, the investigators showed how defining precise gene signatures within colorectal cancer cells helps scientists to develop novel prognostic and predictive markers for the disease, and helps drive the development of more personalized treatments.

“Through analyzing the molecular and genetic data generated from patient tissue samples, we have discovered that there are different subtypes of bowel cancer,” said Dr Philip Dunne, senior research fellow at Queen’s University Belfast. “This research unequivocally identified robust gene signatures that can be used to inform patient management. It will allow us to identify particular gene signatures that indicate sensitivity or resistance to specific therapies. Thus, we can tailor treatments to the individual patient, maximizing its effectiveness while minimizing potential [adverse events.]”

In the UK, colorectal cancer it is the fourth most common type of cancer, accounting for 41,000 new diagnoses per year. Although there are treatment options, mortality rates remain high.

“Personalized medicine aims to give the best treatment to each patient, sparing people unnecessary therapy if it won’t help,” said Dr Catherine Pickworth, science information officer at Cancer Research UK, who helped fund the study. “This is a step toward achieving this, giving us genetic signatures to look out for in [colorectal] cancer patients. The next steps will be to find out which treatment works best for each genetic signature so that cancer treatments can be tailored to each patient, so they have the best chance of beating cancer.”

The study was conducted as part of Stratified Medicine in Colorectal Cancer (S:CORT), which involves key partnerships with patients and advocacy groups.

Ed Goodall, a cancer survivor and member of S:CORT, weighed in on the findings:

“In the past, a tumor was a tumor. Patients are offered chemotherapy and this may not be effective or necessary depending on the patient yet they will still endure all the horrors this treatment can cause including nausea and hair loss,” Goodall said in a press release. “If the oncologist knows more about the subtype of bowel cancer, they will know whether the treatment will be necessary or effective. From a patient point of view, discovering the subtypes of this cancer is really ground breaking work because it will have massive implications for patient care and treatment.”

The findings emphasize the importance of collaborative approaches and new insights into colorectal cancer, and may begin to translate the new knowledge into clinically-relevant applications, noted Tim Maughan, principal lead of the S:CORT Consortium.

“This important study highlights how increasing our understanding of what makes normal cells go wrong is key to developing new approaches that can improve outcomes for patients,” said Deborah Alsina, MBE, chief executive of Bowel Cancer UK. “With nearly 16,000 people dying from bowel cancer each year, it is essential that we increase our understanding of what drives the disease and then improve and extend the range of treatment options available. The results of this study take us a step closer to achieving this.”