Problem addressed, background and strategic significance

Cancer in the back passage often requires treatment with chemoradiotherapy (drugs and X-rays) to shrink the tumour prior to surgical removal, but the response to this treatment is extremely variable. If we could predict which cancers would respond to treatment, we could then tailor the recommendations for treatment for each patient to give a “personalised” medicine programme. Making these predictions requires specific genetic tests done on samples from the cancer before treatment starts. These samples (known as biopsies) need to be big enough to make sure the genetic tests can be done and are accurate. Recent efforts to do this have shown that the samples are simply not good enough. The aim of this study is to develop a standardised way of taking and storing biopsies to make sure that every patient has the opportunity to be offered treatment tailored to their particular cancer. The results of this study can hopefully be used for colon cancer too.

Method(s) used

Previous BDRF funding has facilitated the development of a multidisciplinary group of surgeons and scientists. This group will now prospectively collect tumour samples before and after surgery in a standardised fashion aimed at maximising usefulness for personalised medicine. The results will be compared to similar projects where a standardised protocol was not used.

Hoped for results of this research

This study hopes to develop a method of collecting cancer samples from patients before treatment to ensure that genetic tests can be done accurately and reliably. The results of these will then help doctors advise each patient on the best treatment plan for them and their individual cancer. This project will lay the foundation for the next step which will be working out which genetic tests help best determine response to treatment.

How will this project help build on the Delphi question and what further plans are proposed for future development

The findings of this project will provide key fundamental information to the Delphi multidisciplinary group who are trying to developing biomarkers that predict response to chemoradiotherapy in advanced rectal cancer. It will also allow several other Delphi group progress with providing personalised cancer treatment.
and provide reliable associations between the number of biopsies and amount of material for downstream molecular assessment. Statistical advice kindly provided by Kristian Brock, University of Birmingham