SAN FRANCISCO (KCBS RADIO) – As colon cancer rates increase among young people, researchers from University of Miami Miller School of Medicine have made a new discovery that could help doctors treat patients battling the disease.
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While any people with stage 2 or stage 3 colon cancer receive additional, or adjuvant, chemotherapy following surgery, clinical trials have shown it doesn’t improve the chances of survival for every patient, explained a press release from the university. Dr. Steven Chen, a researcher at Sylvester Comprehensive Cancer Center, led a study published in the Cell Reports Medicine journal that aimed to unravel this mystery.
His team identified and validated “a 10-gene biomarker that potentially predicts whether a stage 2 or stage 3 colon cancer patient will benefit from adjuvant chemotherapy.”
Last spring, Dr. Katherine Van Loon, an associate professor and gastrointestinal oncologist at the Helen Diller Family Comprehensive Cancer Center at UCSF, joined KCBS Radio’s “As Prescribed” to discuss increasing colon cancer rates among Americans under age 50. A report from the American Cancer Society estimated that 20,000 people in the U.S. under the age of 50 would be diagnosed with colorectal cancer that year and that around 3,750 young adults would die from the disease.
“There is an estimation that the vast majority of young-onset cases are presenting with symptoms. Over 80% of cases have associated symptoms at the time of diagnosis,” Van Loon said. “And because we’re not screening the population that’s younger than 45, oftentimes, these cancers are presenting at a much more advanced stage, which can be associated with a much worse prognosis.”
With the new findings, there’s a foundation for further research into the best ways to treat these patients.
“When you’re talking about precision oncology, it means you use an individual patient’s information – here we are particularly talking about biomarkers from the patient – to guide the doctor in making a clinical decision about what kind of treatment is best for the patient,” Dr. Chen said. “Ideally, we only want to apply adjuvant chemotherapy to the patients who will benefit from it. For patients who don’t respond, we still need to find other effective treatments.”
According to the American Cancer Society, the goal of adjuvant chemotherapy is to kill cancer cells that might have been left behind at surgery. It said that the treatment is given in cycles over a three to six-month period and that it can cause symptoms such as: hair loss, mouth sores, loss of appetite, weight loss, nausea, vomiting, diarrhea, nail changes, skin changes, increased chance of infections, easy bruising, easy bleeding, fatigue and more.
“In the United States, most adjuvant therapies recommended by your healthcare professional are likely to be covered by health insurance,” said the Mayo Clinic. “But you may be expected to pay for some part of the treatment. Some medicines and procedures can be expensive.”
Prior to the recent study, scientists have found biomarkers that help doctors predict a patient’s survival curve or understand how aggressive a cancer is. Dr. Chen said the new genetic finding can help guide treatment in a more specific way.
To conduct the research, he reached out to collaborators at Vanderbilt University and Memorial Sloan Kettering Cancer Center. They worked to find a set of genes “whose combined expression patterns can serve as a biomarker,” also known as gene signature.
“Colon cancer patients’ tumors have many different genomic profiles, so the team aggregated gene expression profiles from six publicly available sources to create a 933-patient data set, making it one of the largest gene expression datasets for stage 2 and 3 colon cancer,” said the university press release.
It went on to explain that, “once they were confident the 10-gene network was biologically relevant, they built a model that analyzes the gene signature to predict which patients would benefit from adjuvant chemotherapy.”
Going forward, Dr. Chen hopes the team’s biomarker will be used to help patients and that the study findings may also be used to see if they would benefit from immunotherapy. Work still needs to be done before those things happen, though.
“To be really clinically applicable, we need to go through prospective clinical trials,” he said. “It means we recruit patients and apply this biomarker to see if it’s really effective.”
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