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In a major clinical trial, conducted in the United Kingdom, researchers will try to validate a blood test, which will make it possible to avoid the use of chemotherapy, for patients affected by colorectal cancer.
Will we soon see a small revolution in the management of colorectal cancer? It’s possible.
In the United Kingdom, scientists are currently working to evaluate the relevance of a blood test, which would be able to tell if a patient affected by colorectal cancer at stage 3, needs additional chemotherapy, after his surgery.
“Half of stage 3 cancer patients are cured by chemotherapy alone”
Very widespread, colorectal cancer is the second leading cause of cancer in women and the third in men in France. Once diagnosed, the disease is classified into different stages, depending on its progression. Stage 3 corresponds to the fact that the tumor has spread to the lymph nodes surrounding the colon.
The blood test currently evaluated would be able to avoid chemotherapy for patients. Today, all patients are treated, when in reality half of them are cured by surgery alone. An observation mentioned by Dr. Naureen Starling, principal researcher of the trial to our colleagues at the BBC: “Half of patients with stage 3 bowel cancer are cured by surgery alone, so we over-treat a large proportion of patients.”
A four-year study
This British study, called TRACC, will include 1,621 patients. These will be followed for four years. This will make it possible to judge the relevance of this test and answer “robustly to the question of whether we can spare patients unnecessary chemotherapy if they are negative for circulating tumor DNA (tcDNA) after surgery” can we read on the page of the site of Royal Marsden NHS Foundation Trust of London, dedicated to the test.
A test based on blood markers
But how will this test work? It should be able to search for the presence of tumor DNA in a blood sample. If these traces, which cannot be seen on medical imaging, are found, this means that the tumor is still present. Conversely, in the absence of this circulating DNA, doctors could consider the patient to be in remission, without the need for post-operative chemotherapy.
A gain for the patient, first and foremost, but also for hospital services, as Dr. Naureen Starling further points out. It is “good for the patient, good for the health service, good for cost savings within the NHS. It would be a win-win” she believes. The first results are expected early next year. This test paves the way for other identical approaches, with similar trials underway in the UK for lung and breast cancers.