Patient-tailored treatment for patients with rectal cancer

From 01-01-2009 to 31-12-2010

Description

Recent experimental studies in human xenograft models indicated that VEGF blockade serves as a potent enhancer of radiotherapy, by reducing vascular permeability and tumor interstitial pressure (16;17). The first clinical data in rectal cancer, combining the VEGF inhibitor bevacizumab with chemoradiotherapy showed a significant activity (18). Further studies are needed to confirm the efficacy of these inhibitors in combination with (chemo)radiotherapy in rectal cancer. 

Another way of optimizing treatment is to decrease the toxicity. This could be achieved by the newer irradiation techniques such as intensity-modulated and image-guided radiotherapy (IMRT/IGRT) that could allow reducing the radiation volume. Although these techniques seem promising further research needs to be done in order to determine if the radiation volume can be reduced without compromising the local control of the tumour and to assess whether a simultaneous integrated radiation boost may be an alternative to concomitant systemic treatment.

Interestingly, the response of clinically identical tumors to the (same) neoadjuvant treatment may be different. This suggests that, although rather good results are obtained with the current treatment guidelines, which are based solely on clinical parameters, more “patient-tailored” treatments might in the future give greater benefit. In order to offer patients a patient tailored therapy, it would be of significant clinical relevance to identify predictive and/or prognostic markers of cancer response to radiotherapy or combined-modality therapy. This would allow selection of patients who will respond well to standard treatment to be spared the toxicity of the additional drugs, while other patients might benefit from the addition of an extra treatment. Since the response of the tumours is defined by characteristics of the tumour cells (expression of growth factors, mutations, …) as well as the tumour micro-environment (angiogenesis, inflammation, …), proteins involved in all these processes are potential candidates for biomarkers.

Team

• Bart De Moor, Co-promoter
• Karin Haustermans, Promoter (External)

Financing

Funding: OTHER - Other Funding Agencies

Program/Grant Type: LKI - Leuven Kanker Instituut