Personalized Medicine for the Treatment of Colon Cancer

By Aarti Vaidheeswaran

Overview: Colon Cancer Treatments

Common colon cancer treatment are surgical procedures, radiation therapy, and systemic chemotherapy or immunnotherapy. The treatment regimen is determined based on factors such as the patient's overall health, tumor location, and cancer stage.

Surgical Procedures for Treatment

Surgery is typically the standard treatment for colon cancer.  It usually involves the removal of the tumor and adjacent tissues.  Healthy segments of the colon are reconnected after tumor removal, and surgery might be followed by other treatment methods such as systemic therapy and radiation. Less invasive surgical procedures such as laparoscopy and polypectomy may be carried out to remove tumors or polyps. If the healthy colon segments cannot be reconnected, the surgery is followed by a colostomy where the colon is connected directly to the abdominal wall.  The colostomy is usually temporary to give the colon and rectum post-surgery healing time.

Systemic Therapies (Chemo and Immuno) for Treatment

Systemic therapy involves introducing medicines into the bloodstream, i.e., through the blood vessels, which attack and kill tumor cells or put them in a state of senescence.  In chemotherapy, one or a combination of drugs like Capecitabine, Fluorouracil, Irinotecan, Oxaliplatin are administered depending on the physician's assessment to prevent their growth and rapid division of cancer cells. Boosting immune response is a possible colon cancer treatment option. Checkpoint inhibitors such as pembrolizumab are beneficial immunotherapy options for colon cancer treatment.

Radiation Therapy for Treatment

The medical team might opt for high-energy X-rays to destroy cancer cells in advanced or recurrent cases. These high-energy X-rays might be used as external-beam radiation therapy, stereotactic radiation therapy, intraoperative radiation therapy, and brachytherapy.

Other Targeted Therapies for Treatment

Targeted therapies focus on specific genes such as BRAF or RAS, which are known to be mutated in colon cancer development and are disease targets for therapies. Several classes of targeted therapies include anti-angiogenesis therapies to inhibit blood supply in the tumor, epidermal growth factor receptor inhibitors to stop tumor cell proliferation and, combined targeted therapies.

The Need for More Personalized Treatments of Colon Cancer

Sadly, colon cancer is likely to reoccur in 15.6% of patients treated with surgery and adjuvant chemotherapy and 21.4%1 of patients who received surgery alone. More personalized treatment options are essential to getting better results from colon cancer therapies and reducing the chances of reoccurring [Figure 1]. Improved culture platforms such as 3D organoids are investigated as a physiologically relevant approach to screen novel targeted therapies. These 3D in vitro models can be generated from patient-derived colon cancer cells for a more precise recapitulation of the tumor state and for the identification of personalized treatments for different patients.
 

Figure 1: Personalized treatment options are essential for getting better results from colon cancer therapies and reducing the chances of reoccuring

Reference

  1. Alshehri, K. A., Altuwaylie, T. M., Fakieha, A., AlGhamdi, G., Alshahrani, S. M., & Mikwar, Z. (2020). Recurrence Rate in a Patient Treated with Colon Resection Followed by Chemotherapy in Comparison to a Patient Treated with Colon Resection without Chemotherapy. Cureus. https://doi.org/10.7759/cureus.7544