New Weapons in the Fight Against Colon Cancer

The new lines of research in the fight against cancer involve personalizing treatment as much as possible based on the analysis of each tumor. This is “personalized medicine”, which gathers all the information on each patient in order to treat them accordingly.

In this sense, Dr. Josep Tabernero, Medical Director of the Baselga Oncology Institute, highlights the liquid biopsy. Through a simple blood test it is possible to know the specific particularities of a tumor in order to be able to act directly and effectively on it. “Tumors are all different from each other and during the metastasis process all the versions of a tumor in the organism are not exactly the same because in the process of growth and multiplication of billions of cells they are not all exactly the same,” explains Dr. Tabernero. In addition, “the more treatments it has received, the more alterations it makes. In these cases it is necessary to perform a sequential biopsy”.

Together with liquid biopsy, radiotherapy using the modulated linear accelerator and immunotherapy treatment are some of the latest advances in cancer treatment, which have recently been joined by Ramucirumab, a drug that is administered through the blood and which improves the survival of patients with inoperable metastatic colorectal cancer who no longer respond to the first line of treatment. It is a drug that slows angiogenesis, which is the ability of tumors to generate blood vessels through which to feed and grow. This is the main conclusion of a study led by Dr. Josep Tabernero, medical director of the Baselga Oncology Institute, in which 1072 patients participated and which has been published in the electronic edition of the scientific journal “The Lancet Oncology”.

“The study has corroborated that continuing with the inhibition of angiogenesis, despite the tumor becoming resistant to the first type of chemotherapy, continues to be beneficial and helps to control some diseases”, indicates Tabernero. “We have known for some time that giving antiangiogenic drugs such as Ramucirumab improves the results, although unevenly depending on the tumor,” explains the doctor, who adds that “this study shows that, if a patient who has been treated with the first line of treatment -which consists of chemotherapy plus an angiogenesis inhibitor-, and after a period of time with good results, you change the chemotherapy but also continue to inhibit angiogenesis with another drug that is similar -but not exactly the same as the previous one-, you enhance the effect of the treatment, and after a period of time with good results it stops working well, you change the chemotherapy but you also continue to inhibit angiogenesis with another drug that is similar -but not exactly the same as the previous one-, you enhance the effect of the chemotherapy in this second line of treatment. There was already information on this drug and, for example, it was known that it was active in gastric cancer without having received any other previous treatment and also in lung cancer, but what we have now seen is that in colon cancer this drug is active when first-line treatment fails,” he explains.

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According to the data from the study, slowing angiogenesis prolongs by 16% the survival of patients with mestastatic colorectal cancer who do not respond to first-line treatment and delays disease progression by 21%. From a median survival of 11.7 months, it is now 13.3 months. “The changes are slight,” admits Dr. Tabernero. But he points out that the importance of these data lies in taking the next step in “trying to identify the type of patient who will benefit most from this treatment. The study has confirmed that this is one avenue of research and that we must continue along this path, and the next step is to say, instead of treating a thousand patients, “why don’t we find the hundred who respond best?

Currently, the doctor explains that they are already working on the “search for biomarkers through the analysis of proteins that tell us which patients can benefit the most, since normally what we find is the expression of proteins associated with this angiogenesis signal”.

And he adds: “If we find some factors that stimulate angiogenesis and these are greatly increased in one patient with respect to another, it is more likely that this tumor, which depends more on angiogenesis, if we inhibit it we will have more activity”.