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Colorectal Cancer

Dr. Jonathan Loree - Colorectal Cancer Research, BC Cancer
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Elissa Morrissette
Vice President, Development

Colorectal cancer is the most common cancer to affect both men and women in B.C. This year alone more than 3,200 individuals will be diagnosed and undergo treatment in our province. Research is critical to improve survival rates for these cancers.

When colorectal cancer is detected at its earliest stage, the chance of survival is over 90 per cent. In B.C., individuals aged 50-74 (with no symptoms) should speak with their doctor about the FIT screening test. For more information, please visit the BC Cancer Screening website.

Thanks to donors, breakthrough research and care for those facing colorectal cancer is underway.

New study shows Colorectal Cancer on the Rise in Young People

Dr. Jonathan Loree, medical oncologist at BC Cancer – Vancouver is exploring early onset colorectal cancer. Results show that those diagnosed with colorectal cancer between the ages of 20 and 50 exhibit different clinical and genetic features than those diagnosed after 50 years of age.

The research, published in CANCER, a peer-reviewed journal of the American Cancer Society, is based on analysis of more than 36,000 colorectal cancer patients.

The study also found those diagnosed between 18 and 29 years of age had different clinical and genetic features than other early onset patients who were younger than 50 years of age.

Until now, clinicians grouped patients under 50 years of age together, however the study shows that there are distinct subgroups and that extremely young patients and their treatment plan need to be considered separately.

The rate of early onset diagnoses have been steadily climbing over the past 20 years, while the incidence of colorectal cancer in those 50 years of age and older are falling.

This change in demographics is important and there is a great need for awareness about colorectal cancer in this young group of patients who may not notice early symptoms.

Using a Single Blood Drop to Determine Risk and Treatment

Another area the team at BC Cancer is excited about is “liquid biopsies” to characterize a patient’s tumour. Liquid biopsies are, in essence, a simple blood test, which can be used instead of a standard tumour biopsy.

This test allows oncologists to gain a detailed understanding of a patient’s cancer, with little harm, as standard biopsies can be quite invasive, painful and limited to sampling cancer cells in only one spot.

With the patient’s blood, oncologists can detect their cancer’s mutations and understand what is driving the disease in their body and how it might respond to different therapies.

This in turn, allows oncologists to develop targeted therapies specific to disease, which is unique to every patient, and better predict their responses to treatment.

Further, they can continue to conduct tests throughout the course of the treatment journey with little risk to the patient, enabling them to continue to fine-tune their approach to their disease or change tactics when one treatment stops working.

Using knowledge gained from liquid biopsies and genomics, the BC Cancer team is specifically looking at immunotherapy and how it can treat colorectal cancer cases and potentially improve outcomes.

New Trial Provides Deeper Insight on Treatment Plans

Dr. Loree and a team of researchers recently completed a cross-Canada clinical trial testing immunotherapy for colorectal cancer. Previously, it has been shown that immunotherapy works for the five per cent of colorectal cancer patients who have an abnormality called microsatellite instability (MSI).However, it hasn’t previously been shown to work in the other 95 per cent of patients.

The team now has the results of the trial, which spanned several years, showing that immunotherapy had a small effect on the overall group comprised of 180 patients, discovering some patients responded better to the treatment than others.

This is critical.

The team is now working on analyzing the blood and tumours from patients who were on the trial to see if they can identify a marker.

This will enable patients to benefit more from immunotherapy and will provide better insight into the disease, allowing oncologists to identify the right patients to treat with immunotherapy.