Investigating ways to improve chemoradiotherapy for rectal cancer patients

Lead researcher: Dr Alex Greenhough

Location: University of the West of England

Grant award: £24,969

Dr Alex Greenhough and his collaborators (Mr Adam Chambers and Professor Ann Williams) investigated ways to improve how well chemoradiotherapy treatment works for patients with rectal cancer. In the future, they hope this work will mean more tailored treatment decisions can be made for each individual bowel cancer patient.

The challenge

Patients with rectal cancer are often treated with a combination of chemotherapy and radiotherapy (known as chemoradiotherapy) to shrink their tumour before having surgery. This can reduce the chances of the cancer coming back after surgery.

Chemoradiotherapy doesn’t always work for every patient and this is a particular problem in younger patients.  At the moment it’s not fully understood why one patient might have a better response to treatment than another. Being able to better predict how well this type of treatment might work for each patient could help doctors make more personalised decisions about treatment, reducing the likelihood of patients being given a treatment that simply won’t work for them.

The science behind the project

Dr Greenhough and his colleagues used a set of rectal tumour samples from patients, and measured key proteins in the tumours. They compared these results to the patients’ clinical data — how they had responded to treatment.

The team also grew rectal cancer cells in the lab, where they could remove the key proteins and see what effect this had on how the cells grew.

Results

These experiments showed that a particular protein the researchers looked at could be a useful marker of treatment response. Tumours with high levels of this protein tend to be harder to treat. They shrunk less during chemoradiotherapy and were more likely to have some cancer left behind after surgery.

However, the researchers also found that aspirin might be a way to tackle this. Taking aspirin, or other types of NSAID drugs, was linked to better tumour shrinkage. There’s lots of research going on into how aspirin affects bowel cancer. People with the inherited risk condition Lynch syndrome are recommended to take a daily dose of aspirin to reduce their chances of developing bowel cancer.

What happens next?

The team needs to confirm these findings in more patients and test more directly how it can affect treatment response. This includes working out how aspirin interacts with their protein marker.

The longer-term aim would be to develop a test to identify rectal cancer patients most likely to benefit from chemoradiotherapy so that they can be offered it. Those who wouldn’t benefit could be spared unnecessary treatment and its significant side effects.

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