Priorities in Colorectal Cancer Research: Recommendations From the Gastrointestinal Scientific Leadership Council of the Coalition of Cancer Cooperative Groups

Abstract

Emerging technologies have greatly expanded our ability to detect, characterize, and treat colorectal cancer. The Coalition of Cancer Cooperative Groups convened a multidisciplinary panel, the Scientific Leadership Council in GI cancer, to discuss and advise on the priorities and opportunities to advance current and future approaches into the clinical arena to impact most rapidly the morbidity and mortality from this disease. The Council's recommendations for research priorities are the result of engagement of community and academic oncologists, patient advocacy groups, and other stakeholders including the pharmaceutical industry and governmental agencies. We detail some key prospects for investigation in the areas of colon cancer detection, prevention, and surgical and medical management. Many are in early or definitive clinical trials, and a focus on rapid accrual is urged. The implementation of biology-directed laboratory investigations, both in association with ongoing clinical trials and as a separate developmental strategy for targeted therapies, is supported as the route to individualized therapy.

A ‘metastasis-prone’ signature for early-stage mismatch-repair proficient sporadic colorectal cancer patients and its implications for possible therapeutics

“…Such therapeutic regimen may not yield an optimal benefit to risk ratio [3,4]. Other chemotherapeutics with more efficiency and perhaps less toxicity may be more appropriate for early stage CRC patients.…”

Impact of 18F-FDG-PET/CT on Staging and Irradiation of Patients with Locally Advanced Rectal Cancer

“…Long-term RCT can downstage LARC, increasing the rate of complete surgical resection, allowing more frequent sphincter-sparing surgery, reducing toxicity, and improving pelvic control. The increased utilization of preoperative RCT results in the need of most accurate pretherapy imaging [9,31]. 18 F-fluorodeoxyglucose-positron emission tomography/ computed tomography (FDG-PET/CT) is an established imaging procedure in suspected recurrent colorectal cancer [10].…”

Modulation of thymidilate synthase and p53 expression by HDAC inhibitor vorinostat resulted in synergistic antitumor effect in combination with 5FU or Raltitrexed

“…Although higher response rates have been achieved using the latest poly-chemotherapy regimens, including agents such as 5-fluorouracil (5FU), raltitrexed (RTX), oxaliplatin, irinotecan and the introduction of new molecular targeted drugs such as cetuximab and bevacizumab, almost 50% of the patients die for cancer with an average overall survival of 24 mo in metastatic stage. 1 Intrinsic or acquired resistance to chemotherapy as well as the genetic flexibility of cancer cell genome resulting in multiple and often compensatory survival and proliferative signals, are the cause of the limited activity of anti-cancer strategies.…”