The Genes Behind Colorectal Cancer Relapse

Researchers are developing a diagnostic test for metasizing colon cancer based on the patient’s genetic profile.

AsianScientist (Apr. 2, 2015) – A multi-disciplinary team of doctors and scientists has characterized the genetic changes associated with the spread of colorectal cancer to the liver. This finding, published in Genome Biology, could help to develop personalized diagnostic tests for patients with colorectal cancer.

Colorectal cancer is Singapore’s most common cancer and incidence rates continue to rise. Most patients are initially diagnosed with an early stage disease. However, a proportion of these patients will develop a recurrence of the cancer (metastasis), typically in the liver, one to three years after their colon surgery. If identified early, the liver metastasis may be amenable to surgical removal and the disease can be halted.

“Cancer survivors dread having their cancer recur. Even if this happens, we still have a chance to cure our colorectal cancer patients provided we diagnose it early. Our research findings can have a significant impact on our patients’ quality of life and improve the precision of the treatment they receive,” said co-author of the study, Associatate Professor Tang Choong Leong, Head, Department of Colorectal Surgery at Singapore General Hospital.

To characterize genetic alterations associated with the spread of colorectal cancer to the liver, researchers developed specialized laboratory techniques and computational methods, combining them with DNA sequencing technology.

Out of 750 genes measured, they found that every individual’s cancer had a unique set of about 15 key genetic mutations. Whilst there was little overlap in the specific mutations present between two different patients, the large majority of the mutations found in each patient’s colon tumor were identical to the mutations present in the same patient’s liver metastasis.

“Based on this study, we intend to customize a diagnostic test for each colorectal cancer individual. We will use the unique set of mutations present in that individual’s cancer, as a barcode or thumbprint that we can exploit as innovative diagnostics to monitor for cancer recurrence and diagnose it early,” explained Dr. Iain Tan, co-lead author of the study who is a consultant medical oncologist at the National Cancer Center Singapore and also a clinician scientist at the Genome Institute of Singapore.

The team has been awarded a grant from the National Medical Research Council to further develop this diagnostic test. Tan cautioned that this R&D effort will take several years although he is optimistic that with this finding, further progress could be realized.

The article can be found at: Tan et al. (2015) High-Depth Sequencing of Over 750 Genes Supports Linear Progression of Primary Tumors and Metastases in Most Patients with Liver-Limited Metastatic Colorectal Cancer.


Source: SingHealth; Photo: Shutterstock.
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