Colorectal cancer (CRC) is the third most common cancer in the world with 150,000 new cases each year. At initial diagnosis, 20% of patients have distant metastasis, thus the cancer has spread to other parts and organs of the body and is not confined to the colon or rectum. 25% to 30% of patients with early stage disease will develop metastasis consequently. The subsequent duration of life for metastatic untreated patients is a heart-aching number accounting for a maximum of 9 months.
Currently, using combination therapy approaches, overall survival lengths has been extended to 20 months. The standard of care for metastatic CRC is surgery followed by chemotherapy. There are several approved chemotherapeutic drugs, one of which is the administration of 5-fluorouracil (5FU) with oxaliplatin given mainly through the course of 12 month,s biweekly. The response rate for this treatment is 29%.
Therapy based upon the biology of an individual’s tumour rather than established histopathologic and anatomic classification is an approach that promises to optimise the use of existing therapies. Gene expression analysis offers the potential to measure genome-wide activity which can be used to predict response to current treatments. My project aims at creating a predictive model that can determine which patients are sensitive or resistant to different chemotherapeutic treatment.
In the future, if we, or any other research group, succeeded in reaching this purpose, we would be able to identify the 71% of patients who may not benefit from chemotherapy. I think modifying the standard of care for CRC will have impactful results on the life of patients and this is our ultimate goal as cancer researchers.