Diana Spencer explores the different ways the drug discovery sector is tackling colorectal cancer.
Colorectal cancer is preventable with screening and often treatable when caught early, yet due to late diagnosis and chemotherapy resistance, it remains the second deadliest cancer in the United States.
Held in the US March every year, the aim of National Colorectal Cancer Awareness Month is to improve awareness of the disease in the hope that more cases can be treated in time.
So, what are the recent developments and how is the drug discovery sector tackling this common cancer?
Improved diagnostics
Diagnostics and screening are essential to the early treatment of colorectal cancer. In July 2022, DDW reported that molecular genetics company Mainz Biomed had enrolled its first patient in an international clinical study assessing the potential combination of gene expression (mRNA) biomarkers with a diagnostic test for colorectal cancer.
The ColoFuture clinical study will see Mainz Biomed integrate a portfolio of novel gene expression (mRNA) biomarkers into its ColoAlert detection test for colorectal cancer (CRC), which it is hoped will improve diagnosis and allow more personalised therapy.
Read more: First patient enrolled in mRNA biomarker study for cancer
Immunotherapy
Immunotherapies are offering new ways to treat cancers at advanced stages. In a breakthrough for the disease, a ground-breaking ‘immunoablative’ neoadjuvant immunotherapy clinical trial at Memorial Sloan Kettering Cancer Center (MSK) reported a 100% complete response rate in MMRd locally advanced rectal cancer in 2022.
The researchers confirmed a clinical complete response in all 14 patients who received the immunotherapy treatment dostarlimab as a first-line treatment for mismatch repair-deficient (MMRd) locally advanced rectal cancer.
Read more: Excitement at rectal cancer immunotherapy breakthrough
Combination therapies
One way to overcome treatment resistance is to introduce another active substance. In September 2022, data showed that a new combination therapy could represent a significant advancement in the treatment of metastatic colorectal cancer.
Findings from the SUNLIGHT trial revealed that the combination of trifluridine/tipiracil plus bevacizumab showed a statistically significant improvement in overall survival compared to trifluridine/tipiracil alone. The Phase III clinical trial studied participants with refractory metastatic colorectal cancer (mCRC) following two chemotherapy regimens.
Read more: Trial sheds light on combined treatment for colorectal cancer
Targeted drugs
Over time, chemotherapy induces resistance in most colorectal cancer patients, who end up being unresponsive to the drugs. As a result, the five-year survival rate for those affected is still low.
Late in 2022, a team from the University of Geneva (UNIGE) found a way to overcome chemotherapy resistance in colorectal cancer. The researchers successfully used a combination of tyrosine kinase inhibitors, opening up new avenues for developing therapies that are more targeted than chemotherapy.
Read more: Targeted cancer drug overcomes chemotherapy resistance
RNA-based treatments
In early 2023, Esperovax and Ginkgo Bioworks agreed a partnership to develop circular RNAs (circRNAs) for a variety of therapeutic applications, initially targeting colorectal cancer by inducing cell death only in cancerous cells.
Providing another way to make treatments more targeted, circRNAs represent an emerging, powerful mechanism for delivering therapeutics and vaccines due to their protein-coding potential and improved stability in comparison to their linear mRNA counterparts.
Read more: Alliance to develop circular RNA-based therapeutics
