Colorectal Cancer

Project Title: Phase III clinical trials in colorectal cancer

Start Date: January 2015
End Date: Ongoing

Incentives for a project

Colorectal carcinoma is one of the most common cancer both in men and women with high mortality rate. It is estimated that about 1 million people will be diagnosed annually [1] with about 700000 deaths as a consequence, where geographical distribution of incidence varies across the globe and it is highest in developed countries [2]. Colorectal cancer is heterogeneous disease defined by anatomical location but also by numerous genetic factors. Despite advances in prevention and treatment, it remains one of the most deadly diseases. Population-based screening based on colonoscopy, sigmoidoscopy, and fecal occult blood test are cornerstones of early detection, but several other methods are under development and evaluation (DNA, RNA and protein markers detection). The standard approach for early stages rectal or colon cancer is surgery alone and for more advanced stages (N+, locally advanced tumors, risk factors) is wide excision with adjuvant chemotherapy for colon lesion and neo-adjuvant or adjuvant radio/radio-chemotherapy for rectal cancer. The laparoscopic approach seems to have acceptable oncologic results with lower perioperative morbidity, and endoscopic surgery, as well as local excision, may be an option for selected patients. Adjuvant chemotherapy (FOLFOX) for colon cancer is well established for stage III disease. For rectal cancer, adjuvant chemotherapy is given for stage II and III but data are mostly extrapolated from colon population. The value of chemotherapy in stage II colon cancer is a matter of debate. Targeted therapy does not contribute to better survival in adjuvant settings.

Purpose

It is important to have an overview of ongoing clinical trials in colorectal cancer. Of special interest are phase III trials that may change current practice. This project is ongoing and it is expected that final report will be finished in third quarter of 2016. The project is concentrated on phase III, but we will continue investigation on colorectal cancer trials landscape regardless of trial type or phase.

Keywords

colorectal cancer, rectal cancer, colon cancer, phase III, phase 3, clinical trials