Backed by £5.5m of funding from CRUK and its partners, the hugely ambitious CRC-STARS programme aims to revolutionise how bowel cancer is treated.
Much has been written about the dawn of molecularly targeted cancer therapy. But for people with bowel cancer, progress has been relatively slow compared to other common cancers. And that’s despite the disease’s major molecular pathways being mapped outdecades ago.
Thankfully this is starting to change, with a string of recent discoveries revealing profound new insights into bowel cancer biology.
To translate these into new treatment approaches, a £5.5m consortium of international researchers has recently launched, and is injecting new, and much needed, momentum into the field.
Unmet need
In recent years, a handful of options have emerged to prolong survival for people with metastatic bowel cancer. For tumours that harbour mutations in the MAP kinase signalling pathway, patients can be offered combination therapy with BRAF/MEK and EGFR inhibitors, while those with ‘microsatellite-unstable’ tumours can benefit from immunotherapy. Nevertheless, none of these treatments can cure metastatic disease, and for people without these alterations, there are few options beyond conventional chemo- and radiotherapy.
The only two drugs available for locally advanced disease have been used for 25 years. There’s a real need to develop better options to cure more people.
Progress for people with locally advanced, operable bowel cancer has been even slower. In this setting, while a majority can be cured surgically, a substantial proportion relapse – at which point outcomes are poor. Chemotherapy, either before or after surgery, can boost cure rates – but despite this, around a third of people at this theoretically curable stage of disease, see their cancer return despite systemic therapy.
“These people have very poor outlooks and they’re likely to end up with incurable, metastatic disease,” says Jenny Seligmann, Professor of Gastrointestinal and Translational Oncology at University of Leeds. “The only two drugs available for locally advanced disease – 5-fluorouracil and oxaliplatin – have been used for 25 years, and over that time there haven’t really been any improvements in systemic treatment – either adjuvant or neoadjuvant. There’s a real need to develop better options to cure more people.”…
Credit: by Henry Scowcroft | Cancer Research UK