By harnessing the body’s immune system to target and destroy cancer cells, immunotherapeutic approaches such as immune checkpoint inhibitors have shown significant promise in eligible colorectal cancer patients. Dr Suruchi Aggarwal, Head – Scientific Affairs, MedGenome reveals more
Colorectal cancer, characterised by abnormal cell development in the colon or rectum, has emerged as a major health concern in India. It is a common cancer worldwide and is the third most diagnosed cancer in males and the second in females, with more than 1.4 million new cancer cases every year.
In 2023, a staggering 1,53,020 new cases of colorectal cancer were reported in India, and 52,550 lives were lost to Colorectal Cancer. Even more alarming is that among these cases, 19,550 people under the age of 50 were affected, leading to 3,750 deaths in this younger age group.
To improve treatment outcomes and reduce the disease burden of colorectal cancer, a thorough investigation using sophisticated technologies has become essential. Such tests are now available in India and cover a range of markers using various techniques such as Next Generation Sequencing (NGS), Real-Time PCR (RT-PCR), Immunohistochemistry (IHC), and others. This comprehensive testing approach enhances the diagnostic and individualised treatment capabilities for managing colorectal cancer.
The primary treatment approach to colorectal cancer traditionally revolves around surgical interventions aimed at removing the affected portions of the colon or rectum. While this method remains effective, especially in cases where the tumour is localised and amenable to resection, challenges arise when faced with unresectable cases. Therefore, a nuanced and multidimensional therapeutic approach is essential for comprehensive disease management.
Recent years have witnessed a paradigm shift in the approach to colorectal cancer treatment, with a notable focus on precision medicine. Researchers and clinicians are increasingly emphasising genomic biomarker-based interventions, heralding a new era of personalised and
targeted treatment regimens.
The genomic landscape of colorectal cancer provides valuable insights into the molecular intricacies of the disease. Universal MMR or MSI (Microsatellite Instability) testing is recommended in all newly diagnosed patients with colon cancer, irrespective of the stage of the
disease, the Microsatellite Instability status guides effective clinical management. The landscape of colorectal cancer treatment has seen the rise of targeted therapies designed to interfere with specific molecules involved in cancer growth and progression. Monoclonal
antibodies, exemplified by cetuximab and bevacizumab, are approved for colorectal cancer treatment. These agents disrupt signalling pathways crucial for cancer cell survival and proliferation, however, their effectiveness varies with the molecular profile of the tumour. The treatment strategy for unresectable metastatic disease largely depends on the mutation status of RAS (KRAS and NRAS) and BRAF mutations, and HER2 amplification.
Immunotherapy stands out as a revolutionary avenue in cancer treatment, including colorectal cancer. By harnessing the body’s immune system to target and destroy cancer cells, immunotherapeutic approaches such as immune checkpoint inhibitors have shown significant promise in eligible colorectal cancer patients.
Recognising the heterogeneity of colorectal cancer, researchers are actively exploring combination therapies to address multiple facets of the disease simultaneously. Combinations of traditional chemotherapy, targeted therapies, and immunotherapy are being investigated to optimise treatment outcomes and overcome resistance mechanisms, providing a more comprehensive and effective treatment approach.
The strategy of colorectal cancer treatment is evolving rapidly, driven by advances in genomics and therapeutic modalities. The exploration of alternative strategies, guided by genetic insights, reflects a paradigmatic shift towards precision medicine. As researchers continue to unravel the complexities of colorectal cancer, the integration of innovative therapies offers hope for improved patient outcomes and a more effective arsenal in the fight against this challenging malignancy.
The collaborative efforts of clinicians, researchers, and the healthcare community hold the promise of ushering in a new era of personalised and effective colorectal cancer care.
