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. Clinical trials are important for research and treatment, because they are the only scientific way to prove whether a new treatment works better than current treatments and the only way that a new drug can gain regulatory approval. 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 mutation.
They occur in about 25% of patients
Colorectal cancer originates in the colon or rectum. It is the third most common cancer in both men and women in the U.S., and the second leading cancer in terms of mortality. Most colorectal cancers are a classified as the subtype “adenocarcinoma,” meaning it originates 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. Polyps are often found during preventive screening and are removed, because they can become malignant otherwise. The colorectal cancer mortality rate has decreased with the onset of routine screening starting at age of 50. Preventive screening options include colonoscopy or sigmoidoscopy (flexible scopes that look inside the colon and rectum) and fecal occult blood tests that detect minute amounts of blood in the stool.
History of Colorectal Cancer Research
The past 20 years have seen great progress in colorectal cancer research. Based on research, we now know 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 caused by inherited gene mutations, which occur in about 25% of patients. Learn more from the American Society of Clinical Oncology (http://www.cancer.net/cancer-types/colorectal-cancer/risk-factors-and-prevention)
Some examples of known inherited mutations are familial adenomatous polyposis (FAP) and Gardner syndrome, which are caused by changes in the APCgene, a gene that usually controls cell growth. Individuals with these genetic mutations do not have a way of turning off cell growth and therefore have extensive overgrowth of polyps, increasing their chance of developing colon 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 physicians and ask about genetic testing to determine their risk. Learn more from the American Society of Clinical Oncology
Other gene mutations that can lead to colorectal cancer are acquired during a person’s lifetime and only affect the cells that come from the original mutated cell. One group of genes in this category is called the RAS family, which play a key role in cell growth and division. Changes or mutations in RAS genes result in permanently “turned on” switches that allow cells to divide uncontrollably, potentially resulting in malignancy. There are several known types of RAS oncogenes, with “KRAS” being the most common in colorectal cancer. It is estimated that 40-50% of human colorectal cancers have mutated KRAS genes. Tumors with 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 blocks the signal that would otherwise lead to uncontrollable growth of the cancer cells. Recent studies highlight the increasingly important role of genetic assays in identifying cancers that will be more susceptible to specific treatments. Learn more from CancerConnect.com
Another mutation associated with colorectal cancer 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. There has been an ongoing debate regarding the effectiveness of chemotherapy in treating early-stage colorectal cancer after tumors have been surgically removed. By utilizing molecular profiling testing, the genetic profiles of aggressive tumors can be compared with the less aggressive ones to determine the overall “profile” and potential to respond to therapies. This approach allows patients who would most likely be poor responders to avoid unnecessary treatment, and its side-effects. 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 colorectal cancer trials or studies related to some other form of cancer, it can be hard to find trials that might be a good match.
When you get started with Cure Forward, your personal Clinical Trial Navigator with help you and your care team build a robust profile inclusive of your full medical history, personal preferences, and molecular profile (when applicable), all at no cost. We are able to provide this free service, because we focus on building robust profiles so we can match patients with relevant and active clinical trial options, opening the door to advanced treatments for patients and accelerating medical innovation. 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.