One “more step” towards personalized medicine in colon cancer

Is about know in advance which patient will respond well to a treatment and who will not. The reproduction of tumors, one of the nightmares of every cancer patient, is not random. What’s more, the study in which the Biodonostia team led by Dr. Luis Bujanda participated, in collaboration with other State work groups and directed by an American researcher, delves into the idea that own genetic makeup has a significant impact on it. The prestigious scientific publication Molecular Cancer has echoed this work, which means taking “one more step towards a personalized treatment, tailored to each patient, for colon cancer”. Translated: save lifes.

If cancer is currently the most frequent cause of death in human beings, the second type of tumor that causes the most deaths is precisely that of the colon, after lung cancer. We are talking about more than 2,000 new ones detected every year in the BAC. There is no other with higher prevalence. “If you take 100 individuals with colon cancer in a row, after five years 30 die. Survival is 70%,” explains Bujanda himself.

Every year more than 2,000 new colon cancers are detected in the CAV

The study in which his team has participated opens the way precisely to the near future with much more effective, personalized treatments. And what they have observed is that “the determination of 10 microRNAs in blood and/or tissue can help us to select those patients who have more chances of getting cancer again despite the administration of chemotherapy with Folfox, the mixture of drugs most used in the treatment of this type of tumors”, he adds.

The team of Doctor Bujanda has been systematically collecting data from patients with digestive pathologies since 2009 at the University Hospital of Donostia (HUD). They do so with various types of gastrointestinal cancer: especially the colon, but also of the pancreas and others that are rarer as well as lethal, such as bile duct cancer. “In colon cancer we have collected samples from around 1,000 sick patients,” he points out.

Colon cancer survival is 70% at 5 years

Bujanda He is a benchmark in colon cancer research and one of his papers, precisely, was published in 2012 in the most prestigious scientific journal in the medical field worldwide (The New England Journal Medicine); Y contributed to the implementation of colon screenings (detection of blood in feces), a test that, thanks to his work and that of others, is carried out today by numerous health systems in the world, including ours, and “saves thousands of lives.”

Screenings detect 25% of colon cancers in very early stages, which “can only be cured with endoscopy or surgery”

“With screening programs, 25% of colon cancers are detected in very early stages, which can only be cured with endoscopy or surgery; then there are those that are very advanced, which would be 15 or 20%; and in the middle are these two groups that we are doing the study (stage II and III), that despite performing surgery and removing it at the moment, it can sprout again ”, explains this doctor and researcher.

And in those cases, to try not to get it again, explains Bujanda, “oncologists give chemotherapy or drugs against tumor cells. And chemotherapy has always been the same for everyone, open bar. You have a risk of this, because you have to give yourself A; that A fails, then I give you B; then the C; and so on, ”she assures. Until “There are currently more than 10 different drugs” available today for colon cancer.

Big progress in sight

But studies like this are changing the treatments. Less to go, says Bujanda. It is “changing the mentality. And now you have to give the chemotherapy that works for you based on your clinical characteristics and your genetic profile. We can predict if chemotherapy will respond to you, with a high degree of reliability, ”he explains excitedly.

“This means doing a genetic profile to determine before giving you chemotherapy, if it is going to be effective, or we are throwing money away, or we are exposing you to a very aggressive therapy, with many side effects and that is not going to work for you” . Because there are more solutions. And great advances are taking place in this field.

What has to come now, explains Bujanda, are new studies that endorse these results” and justify the direct application of specific drugs that can cost “10,000 euros”when the most common, much cheaper, “we know it works pretty well in most cases.”

specific immunotherapy

“The study goes a little to direct profiles so that you can select the most appropriate drug for each patient from the outset. That is personalized medicine: don’t give me everyone’s, but what suits me best, what will work for me and also will not produce undesirable or secondary effects”, explains this specialist.

Personalized medicine, “in practice”, is not accessible to the common patient, says Bujanda, but it is getting closer, “because some very relevant studies have been published, especially in the last year, which are the ones that have marked the guideline”. Especially in relation to immunotherapy, which “for some specific genetic characteristics, makes the entire tumor disappear without operating, without giving aggressive chemotherapy or radiotherapy. That is, what they do is activate their own defenses to attack the tumor cells, in such a way that they kill it. That marks a before and after ”, he concludes.

77 patients from the Donostia Hospital

This study on colon cancer has been carried out in 2 cohorts of patients who were recruited at the Hospital Universitario de La Paz, in Madrid (71 patients), and at the Hospital Universitario Donostia de Donostia (77 patients). And they have participated in it, in addition to the team of Dr. Bujanda from Biodonostia, researchers from the Hospital Clinic of Barcelona, ​​Hospital Quiron of Valencia, Hospital Universitario and Politécnico La Fe in Valencia. All of them coordinated by Dr. Ajay Goel, from the Baylor University Medical Center in Dallas, United States. “It is one more step towards personalized medicine in colon cancer”, concludes Bujanda. The results have been published in the journal molecular cancer.

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