Cancer is a complex and challenging disease to treat, but one of the most powerful tools for stopping it lies within us: our immune system.
This fact is particularly important in bowel cancer (colorectal cancer). Scientists have found that bowel tumours with larger numbers of immune cells in specific areas have a lower risk of returning after surgery. It’s as if these tumours are hemmed in by the body’s defences, so it’s harder for individual cancer cells to escape the surgeon’s knife.
Soon, doctors could have a new way of working with those defences, making the treatment decisions that come after surgery much easier. An expert team led by one of our researchers has shown that an AI test can analyse important CD3 immune cells in stage 2 bowel tumours and identify the people who most need chemotherapy as a secondary shield to stop their cancer coming back.
The study, which was published in the Journal of Clinical Oncology last year, was conducted by the National Pathology Imaging Co-operative (NPIC) through a grant from Innovate UK.
“This has the potential to be the most important test patients with early-stage bowel cancer ask for,” says Dr Christopher Williams, the lead researcher and a Cancer Research UK Clinical Trials Research Fellow at the University of Leeds’ School of Medicine.
Williams, who specialises in treating people with bowel cancer, is speaking from experience.
“It’s one of the most difficult conversations that we have in the clinic: should you or shouldn’t you have chemotherapy after your surgery,” he says. “And that conversation is most difficult in stage 2 bowel cancer, where your chances of benefit, we know, are lesser.”
Picking the right path for stage 2 bowel cancer
Thanks to our QUASAR trial, which ran from the 1990s into the 2000s, we know that giving people with bowel cancer chemotherapy after surgery helps more of them stay cancer-free for longer.
Credit: by Sadaf Shafaghmotlagh , Tim Gunn