Colorectal Cancer Clinical Trials
Clinical trials are research studies that evaluate whether a new drug, treatment, or combination of treatments is safe, effective and possibly better than the current standard-of-care for colorectal cancer. They are important for research and treatment as they are the only scientific way to prove whether a new treatment works better than current treatments. In fact, nearly all cancer drugs in use today were tested and made available to patients through clinical trials.
It is important that you know all of your options. For many people, particularly those whose cancer has not responded to standard treatments, a clinical trial may be the best available treatment option.
Colorectal cancer can be due to inherited gene mutations
They occur in about 25% of patients
Colorectal cancer is cancer that originates in the colon or rectum. It is the third most common cancer in both men and women in the U.S., and is the second leading cancer in terms of mortality. Most colorectal cancers are a classified as the subtype“adenocarcinoma”- originating from cells that make and release mucus and other fluids. In many patients, colorectal cancer begins as a growth (polyp) on the inner wall of the colon or rectum and can become malignant if not removed. Colorectal cancer mortalities have decreased with the onset of routine screening over the age of 50 to catch it earlier, which includes options such as colonoscopy or sigmoidoscopy (flexible scopes that look inside the colon and rectum) and fecal occult blood tests that detect minute amounts blood in the stool.
History of Colorectal Cancer Research
The past 20 years have seen great progress in colorectal cancer research. Some helpful learnings have been that early polyp removal can be an effective way to prevent colon cancer and that aspirin therapy can extend the life of patients who carry a specific gene mutation. Learn more from the Dana Farber Institute
A key recent discovery was that colorectal cancer can be due to inherited gene mutations, which occurs in about 25% of patients. Learn more from the American Society of Clinical Oncology
Some known examples of inherited mutations are Familial adenomatous polyposis (FAP) and Gardner syndrome which are caused by changes in the APCgene that usually controls cell growth. Those with mutations in this gene do not have a way of turning off cell growth and therefore have extensive overgrowth of polyps, increasing their chance of developing cancer. Lynch syndrome (hereditary non-polyposis colon cancer, or HNPCC) is caused by changes in genes that normally help a cell repair faulty DNA, and Peutz-Jeghers syndrome is caused by inherited changes in the STK11 gene that may suppress tumor growth. Those with a family history of polyps or colorectal cancer should discuss this history with their physician and ask about genetic testing to determine their risk. Learn more from the American Society of Clinical Oncology
The other gene mutations are acquired over one’s life, and only affect only cells that come from the original mutated cell. One group of genes discovered is called the RAS family, which play a key role in cell growth and division. Changes or mutations in the RAS genes result in permanently “turned on” switches that allow cells to uncontrollably divide, potentially resulting in malignancy. There are several known types of RAS oncogenes, with one called “KRAS” being the most common in colorectal cancer. It is estimated that 40-50% of human colorectal cancers have mutated KRAS genes. Those tumors that have nonmutated, or wild-type, KRAS are susceptible to a class of biologic agents called epidermal growth factor receptor (EGFR) inhibitors. EGFR is a receptor on the surface of the cell that binds to a growth factor called epidermal growth factor (EGF). This receptor activates cellular pathways that promote cell growth and division, with KRAS being one of the key players in the process. Blocking the EGF receptor removes this important signal for the continued growth of cancer cells. Recent studies show the increasingly important role of genetic assays to identify cancers that will be more susceptible to specific treatments. Learn more from CancerConnect.com
Another mutation is BRAF (about 10% of colorectal cancers) that also results in increased cell division. Studies have shown that BRAF mutations may predict a poorer response to EGFR inhibitors.
Current Colorectal Cancer Research
Genetic testing and molecularly targeted therapies are at the forefront of colorectal cancer research. It has been an ongoing debate regarding the effectiveness of chemotherapy in early stage colorectal cancer after tumors have been surgically removed. By utilizing molecular profiling testing, genetic profiles of aggressive tumors can be compared with the less aggressive ones, to determine the overall “profile” and potential to respond to therapies, and therefore sparing those that would be poor responders the side-effects of unsuccessful treatment. Learn more from CancerConnect.com
KRAS is the most common gene in colorectal cancer. It is estimated that 40-50% of human colorectal cancers have mutated KRAS genes.
Why Cure Forward?
Whether you’re seeking information about basket cancer trials or studies related to some other form of cancer, it can be hard to find trials that might be a good match.
Through our Clinical Trial Exchange, Cure Forward collects data on clinical trials and studies from multiple sources making it easier to find all the options that are available for you or your loved one. We work directly with clinical trial recruiters to help introduce their trials to potential candidates.
No more scouring the Internet. Our Clinical Trial Exchange brings current, active studies directly to you.