Colon Cancer Clinical Trials

What is Colorectal Cancer?

Colorectal cancer is a type of cancer that develops in the colon or the rectum, which are parts of the large intestine. It often starts as small, noncancerous (benign) clumps of cells called polyps that form on the inside of the colon. Over time, some of these polyps can become colon cancers. The main types of colorectal cancer are:

Adenocarcinomas: This is the most common form, making up about 95% of colorectal cancers. Adenocarcinomas start in cells that make mucus to lubricate the inside of the colon and rectum.

Carcinoid Tumors: These start from special hormone-producing cells in the intestine. Though less common, they are part of a group of diseases called neuroendocrine tumors.

Gastrointestinal Stromal Tumors (GISTs): These rare tumors start in a type of cell in the wall of the colon called the interstitial cells of Cajal. Some are benign; others are cancerous.

The type of colorectal cancer can influence both treatment and prognosis. However, most people with colorectal cancer have adenocarcinomas, and the general term “colorectal cancer” usually refers to this type.

Treatment options for colorectal cancer depend on the stage of the cancer, its location, and the overall health of the patient. Common treatments include:

Surgery:

Procedures like polypectomy or endoscopic resection for early stages.

Partial colectomy for more advanced stages.

Low anterior resection or abdominoperineal resection for rectal cancer.

Radiation Therapy:

Used before or after surgery, sometimes in combination with chemotherapy, particularly in rectal cancer.

Chemotherapy:

5-Fluorouracil (5-FU) and Capecitabine (Xeloda) are commonly used drugs.

Administered after surgery to kill remaining cancer cells or before surgery to shrink tumors.

Also used for advanced cancers to improve symptoms and prolong life.

Targeted Approach:

Drugs like Bevacizumab (Avastin), Cetuximab (Erbitux), and Panitumumab (Vectibix) target specific pathways or proteins in cancer cells.

Mainly used for advanced colorectal cancer, especially if it has metastasized.

Immunotherapy:

Drugs such as Pembrolizumab (Keytruda) and Nivolumab (Opdivo) are used for cancers with specific genetic markers.

Effective particularly in advanced stages of colorectal cancer.

Next-Generation Sequencing (NGS) is vital in linking patients with specific genetic mutations in their cancers to clinical trials for targeted options.

In colorectal cancer, certain genetic alterations are commonly observed, which contribute to the development and progression of the disease. Some of the key genes frequently altered in colorectal cancer include:

APC (Adenomatous Polyposis Coli): Mutations in the APC gene are among the most common genetic changes in colorectal cancer. They are especially prevalent in hereditary cancer syndromes like Familial Adenomatous Polyposis (FAP) and also occur in sporadic (non-hereditary) cases. APC mutations lead to uncontrolled cell growth.

KRAS: Mutations in the KRAS gene are common in colorectal cancer. These mutations lead to abnormal cell growth and division and are associated with resistance to certain targeted approaches.

BRAF: The BRAF gene, when mutated, can contribute to the growth of cancer cells. BRAF mutations in colorectal cancer, particularly the V600E mutation, are associated with a poorer prognosis and are important in planning.

PIK3CA: This gene, when mutated, can activate pathways that promote cell growth and survival. PIK3CA mutations are seen in a subset of colorectal cancers.

TP53: TP53, often referred to as the “guardian of the genome,” is a tumor suppressor gene. Mutations in TP53 are common in colorectal cancer and are associated with the progression from a benign polyp to a malignant tumor.

Clinical trials play a crucial role for stage 3 and stage 4 colorectal cancer for several reasons:

Access to New Options: Clinical trials offer patients a chance to try new options that could work better, especially for serious illnesses like advanced colorectal cancer.

Improving Outcomes: By participating in clinical trials, patients contribute to knowledge that could improve survival rates and quality of life for future colorectal cancer patients.

Comprehensive Care: Patients in clinical trials often receive a high level of care and are closely monitored by a dedicated team of healthcare professionals and researchers.

Hope for the Future: For many patients with advanced colorectal cancer, participating in a clinical trial provides hope—both for themselves and the possibility that their participation will help others in the future.

Advancing Research: These trials are essential for research, helping scientists understand how new options work and for whom they work best. This can lead to the development of more effective strategies and personalized medicine.

Cancer is an unfortunate reality that touches most of us at some point in our lives. If you or a loved one has cancer, you may have heard or read that clinical trials could offer access to innovative new options. But what exactly is a clinical trial? In this video, Massive Bio co-founder Arturo Loaiza-Bonilla, MD, explains how clinical trials work, what to expect if you enroll in one, and why a clinical trial can be an important option for many cancer patients.

We dream of the day when cancer disappears from our lives. Massive Bio is working tirelessly on achieving that goal.