Colon cancer – how to predict?

Researchers at IRB Barcelona discover how to refine the prognosis of these tumors.

Colon cancer is unpredictable. About 40% of those suffering from the area located in bowel tumor relapse in the form of metastases, so far, science has been able to determine clearly which cases are at risk.

In recent years molecular classifications have been developed that allow classify patients according having forecast, although still improvable. An investigation by the Institute of Biomedical Research of Barcelona has now got one step further in this line and shed light on what it is that allows to know how a tumor will behave in the future. The fact of the matter is not in the malignant cells, but in healthy cells surrounding the tumor, called stroma.

The key is the ability of the tumor to pervert their environment. Colon cancer reappears as matastases in those patients in which tumor cells are able to exert this influence in the cells around it. The basis of classifications is therefore whether the tumor stroma is altered or not.

After studying the genetic profile of tumors nearly 1,000 patients worldwide, the researchers found that the molecule TGF-beta played a fundamental role of 'corrupting' neighboring cells.

It is not the first time scientists point the finger to this molecule involved in cell growth and division. Other studies have already shown their 'guilt' in the spread of breast cancer.

According to researchers, they explain TGF-beta establishes communication with the cells surrounding the tumor and encourages them to develop changes that spread tumor.

Model in vitro

To go one step further in their work, these scientists developed tumors miniature laboratory samples from patients and showed that if the action of TGF-beta is blocked, also slowed tumor progression.

The researchers propose that the possibility of using TGF-beta inhibitors for the treatment of colon cancer is explored, remember that there are several such inhibitors whose effectiveness against other cancers being studied now. In this sense, the researchers encourage the pharmaceutical industry and oncologists to join and investigate a therapy that can be beneficial for patients.

On the other hand, the ITB is finalizing the details of a diagnostic test that will identify patients with colon cancer are more likely to develop metastases.

The tool, called Colostage, is designed to detect if the tumor environment, the stroma, are altered, which will be crucial to make a better estimate of risk and to the oncologist.

Analyzing the genes expressed in the 'neighboring environment' tumor you can find out which patients are at higher risk of relapse. In these patients, it can be planned closer monitoring and propose a more aggressive therapy.

Similarly, the ability to hone in on a diagnosis can also prevent many patients undergo radiation treatments or chemotherapy unnecessarily.

Now, all stage III patients are treated. And the reality is that some do not relapse. The test can help identify when it's not necessary.

The proof of concept of this test will be ready in the next 6 months, although it will take a long way of testing and approval before it is available in hospitals queries. The study has involved various departments and specialists IRB Hospital del Mar and the Autonomous University of Barcelona.

In the same journal the result of a study led by researchers at the Cancer Institute of Candiolo (Italy) which, independently, has reached similar conclusions to those published and also demonstrates the crucial role of the stroma the advancement of colorectal cancer.

Colon cancer is one increasing more in Western countries. It is the third most common cancer in men, behind lung and prostate. In women, it ranks second, following breast cancer. It is one of the few cancers that can be diagnosed early, before any symptoms. Physical inactivity, unbalanced supply and consumption of snuff and alcohol are some of the factors that have been associated with an increased risk of developing a tumor of this type.