A blood test allows you to choose the best treatment for colon cancer and allows us to identify the most effective tailor-made treatment for each individual patient affected by cancer. The results announced by the European Institute of Oncology (Ieo) in Milan and published in ‘Annals of Oncology’ are a step forward on the road to precision oncology. A new hope for those suffering from advanced colorectal cancer.
Young researchers from the Ieo Medical Oncology of Gastrointestinal and Neuroendocrine Tumors (Gi/Net) and Development of New Drugs divisions, in collaboration with the Southern Italian Oncology Group (Goim) – informs the Irccs founded by Umberto Veronesi – have achieved thanks to the liquid biopsy extensive molecular profiling of cancer, which it allowed the analysis of over 300 genes compared to the small number of genes evaluated in clinical practice with traditional tissue biopsy. Since the new drugs are targeted at the genetic alterations of each individual tumor, more genes analyzed means being able to identify the best possible therapy for each patient.
“To date, the therapeutic choice in patients with advanced colon cancer is based on the analysis of a few genes performed on tissue biopsies”, explains Davide Ciardiello of the Gi/Net Medical Oncology Division, creator and first author of the study. “What we have discovered – he reports – is how the liquid biopsy, in patients with colorectal tumors defined as ‘Ras/Braf non-mutated’, can identify a universe of molecular alterations, capturing the heterogeneity of tumor cells. In fact, in ‘actionable’ genetic alterations were detected in over half of the patients, i.e. targets on which targeted drugs are active. Furthermore, using the same extended molecular profiling test on both the blood and tissue samples we observed how the liquid biopsy can. be not only equivalent, but in some cases superior to the solid one”.
“To date – underlines Ciardiello – one of the most difficult obstacles in the treatments of this patient population is represented by the existence or development of drug resistance mechanisms. When these mechanisms are present, as in a game of chess, we researchers must find a move for which the tumor cannot find a counter-move. For this reason, the possibility of knowing the molecular identikit of the tumor before, during and after the therapy through a simple blood sample can allow us to offer each patient. a personalized therapy”. In other words, to checkmate cancer.
The study data
The Capri-2 Goim study involved 25 Italian reference centers and recruited 205 patients with metastatic colorectal cancer who were candidates for treatment with epidermal growth factor (EGFR) inhibitor drugs. The objective is to establish the optimal therapeutic sequence in patients with tumors initially defined as Ras/Braf non-mutated, across different lines of treatment. The trial has completed enrollment and is currently underway. After progression to the first line of therapy, the choice of subsequent treatments will be guided by the result of extensive molecular profiling via liquid biopsy, thus allowing the optimization of the therapeutic program.
“We are proud, as the Gi/Net Medical Oncology Division – comments the director of the division Nicola Fazio, co-author of the work – of the liveliness and scientific resourcefulness that Davide Ciardiello has shown in knowing how to seize the opportunity of an important study like the Capri- 2 to develop, in collaboration with Goim and the Ieo New Drugs Division directed by Professor Giuseppe Curigliano, an independent research project thanks to which the significant role that liquid biopsy can have in metastatic colon cancer was highlighted and validated In the era of precision medicine, a broad characterization of the molecular profile of the tumor is the key to moving from a one-size-fits-all therapy to a tailor-made treatment for each patient “.
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