Problem addressed, background and strategic significance

Colorectal cancer cells spread by entering the bloodstream and circulating around the body. These circulating cancer cells can leave the blood and start growing in a distant organ.  Within the bloodstream, cancer cells interact with cells called platelets. Platelets normally help the blood to clot when there has been an injury. Research demonstrates that the interaction between cancer cells and platelets helps the spread of cancer.  Drugs which block platelets (anti-platelets) are used as a treatment for heart attacks.  Anti-platelet drugs could also block the interaction between platelets and circulating cancer cells and potentially reduce the spread of colorectal cancer.  We are investigating this in a clinical trial where colorectal cancer patients and healthy volunteers take two anti-platelet drugs (Aspirin and Ticagrelor).  Blood samples are collected during treatment to investigate how the drugs change the interactions between circulating cancer cells and platelets.  Cancer cells are known to produce and release large amounts of free DNA into the bloodstream.  The amount of free DNA and circulating cancer cells can be measured from blood samples and can be used as markers to show how a treatment is working.  Measuring these marker levels in trial blood samples, we will investigate how they change with anti-platelet treatment.

Method used

Blood samples from colorectal cancer participants will be taken at each treatment point. Circulating cancer cells will be counted and examined under a microscope to determine their size, shape and contents. Levels of free DNA will also be measured at each treatment point.

Hoped for results of this research

If anti-platelet treatment causes changes in the circulating tumour cells and the free DNA levels, we would gain insight into how the platelets and circulating tumour cells interact to cause spread.

How will this project help build on the BDRF Delphi Research Strategy and what further plans are proposed for future development?

The project will further understanding into how colorectal cancer cells spread and demonstrate how anti-platelet drugs could reduce this.  The way the disease markers change in response to anti-platelet therapy would provide evidence for further investigation in larger clinical trials, potentially benefitting a huge number of patients.