What`s new in colorectal cancer research and treatment?
Research is always going on in the area of colorectal cancer. Scientists are looking for causes and ways to prevent colorectal cancer as well as ways to improve treatments.
Tests (including Oncotype Dx® Colon Cancer Assay, ColoPrint®, and ColDx™) have been developed that look at the activity of many different genes in colon cancer tumors. These tests can be used to help predict which patients have a higher risk that that the cancer will spread. So far, though, none of them have been shown to help predict who could benefit from chemo or other treatments.
Researchers have developed a test that can find areas of colon cancer spread in nearby lymph nodes that wouldn’t have been found with the test normally used. By recognizing a kind of RNA that is found in colon cancer but not in normal lymph node cells, this may help identify patients who have a higher stage of colon cancer than originally suspected, and who might benefit from chemotherapy after surgery.
Newer surgery techniques
Surgeons are continuing to improve their techniques for operating on colorectal cancers. They now have a better understanding of what makes colorectal surgery more likely to be successful, such as making sure enough lymph nodes are removed during the operation.
Laparoscopic surgery is done through several small incisions in the abdomen instead of one large one, and it's becoming more widely used for some colon cancers. This approach usually allows patients to recover faster, with less pain after the operation. Laparoscopic surgery is also being studied for treating some rectal cancers, but more research is needed to see if it as effective as standard surgery.
With robotic surgery, a surgeon sits at a control panel and operates very precise robotic arms to perform the surgery. This type of surgery is also being studied.
Different approaches are being tested in clinical trials, including:
- New chemo drugs or drugs that are already used against other cancers (such as cisplatin or gemcitabine).
- Chemo that does not include 5-FU for patients whose colorectal cancers show microsatellite instability (MSI). People whose cancers have this molecular feature tend to survive longer after surgery, but they may be less likely to be helped by chemotherapy combinations that include 5-fluorouracil (5-FU) given as adjuvant treatment after surgery.
- New ways to combine drugs already known to be active against colorectal cancer, such as irinotecan and oxaliplatin, to improve their effectiveness.
- The best ways to combine chemotherapy with radiation therapy, targeted therapies, and/or immunotherapy.
Several targeted therapies are already used to treat colorectal cancer, including bevacizumab (Avastin), cetuximab (Erbitux), and panitumumab (Vectibix). Doctors continue to study the best way to give these drugs to make them more effective.
Targeted therapies are currently used to treat advanced cancers, but newer studies are trying to determine if using them with chemotherapy in earlier-stage cancers as part of adjuvant therapy may further reduce the risk of recurrence.
Researchers are studying several vaccines to try to treat colorectal cancer or prevent it from coming back after treatment. Unlike vaccines that prevent infectious diseases, these vaccines are meant to boost the patient's immune reaction to fight colorectal cancer more effectively.
Many types of vaccines are being studied. For example, some vaccines are created by removing some of the patient's own immune system cells (called dendritic cells) from their blood, exposing them in the lab to a substance that will make them attack cancer cells, and then putting them back into the patient's body. At this time, these types of vaccines are only available in clinical trials.
Last Medical Review: 10/15/2014
Last Revised: 11/01/2014