Finding better treatment options for aggressive bowel cancers

Pictured (L-R) Professor Helen Abud and Dr Rebekah Engel
Pictured (L-R) Professor Helen Abud and Dr Rebekah Engel

Bowel cancer researchers are investigating how to find the right treatment for an individual patient’s cancer faster by growing copies of their tumour in the lab.

Melbourne researcher Professor Helen Abud and colleagues have taken tumour cells from patients who have an aggressive subtype of bowel cancer and successfully grown them into tumours in test tubes. They are now trialling these lab tumours as a testbed to quickly determine how effective drugs are likely to be in individual patients.

The cells come from tumour biopsies and so retain the genetic blueprint of the patient’s original tumour. The National Stem Cell Foundation of Australia is backing the trial through its Matched Funding Program.

Professor Helen and her team at the Monash Biomedicine Discovery Institute is conducting the trial in partnership with Professor Paul McMurrick, Dr Rebekah Engel and colleagues at the Cabrini Department of Surgery. Together, they hope that testing such treatments in lab tumours before patients commence chemotherapy will allow researchers and oncologists to trial an array of drug combinations and determine how well each individual patient’s cells respond. This information can then be used to prescribe effective care and avoid the side effects and costs associated with futile therapy.

Colorectal or “bowel” cancer is relatively common and has a high mortality rate in Australia.  More than 17,000 new cases are diagnosed each year and over 4,000 deaths were attributed to it.

“We’re trying to have an impact on a particularly aggressive subtype of bowel cancer, that carry a mutation in a gene called BRAF,” Professor Abud explains. “About 10 per cent of patients with bowel cancer have this subtype, and they have a very poor prognosis, with a median survival of less than 12 months.”

Typical treatment involves surgery to remove the tumour, followed by chemotherapy, of which the side effects can include nausea, diarrhoea, hair loss, and infections resulting from a weakened immune system.

Some patients respond well to treatments, some have only a short-term response, and some do not respond at all.

“We want to give patients only treatments that are effective, and prevent them from experiencing side effects if the treatment has no benefit to them. We also want to avoid wasted cost to our healthcare system,” Professor Abud says.

Following surgery, patients have time to recover, before their oncologist prescribes a chemotherapy regimen.

“Because we can grow the tumours pretty quickly, we think it’s possible to grow them, test a panel of drugs, and give feedback to the oncologist, so they have that information in time to guide treatment decisions for patients before they commence therapy in the clinic,” Professor Abud says.

“But first we have to prove that the system works.”

Professor Abud says previous studies in some other subtypes of bowel cancer have shown that patient-derived lab-grown tumours mimic real-life response to treatment.

“We’ve collected 10 BRAF tumours already, and we’re continuing to collect more, so that we’ve got a good sample size to see if this testing platform works within the timeframe needed to fit in with a patient’s treatment.”

The study also includes a cohort of patients already undergoing therapy to see if their tumour organoid responses do indeed mimic what oncologists observe in their actual clinical responses to treatment.

The National Stem Cell Foundation has provided $50,000 to support Professor Abud's research, matching a $50,000 donation from Let’s Beat Bowel Cancer, a not-for-profit initiative affiliated with the Cabrini Foundation that aims to lower bowel cancer-related deaths through public awareness, research and medical advances.

If all goes well, the evidence from this project will help Professor Abud and her team of collaborators attract funding for larger studies from government sources, cancer charities, gastrointestinal trial networks, and others associated with clinical partners.

“When you have an idea that could solve a problem, you just really want to get into the lab,” says Professor Abud. “Inspiring discussions between clinicians, scientists and patients and their families have made us think, ‘Gosh! We have to do something about this particular subtype.’”

The researchers will work with oncologists to design a clinical trial implementing the lab-grown tumour testing platform in several hundred patients with a view to it becoming part of standard care moving forward.

“We want to reduce suffering of patients and make our health spending as effective as possible. If you look at the cost-benefit of developing a testing system like this, it’s hugely beneficial to both patients and the health system,” Professor Abud said.

Donations from the public allow the National Stem Cell Foundation to keep funding its half of the contribution to important treatment research projects selected for the Matched Funding Program. If you would like to support them with a donation, visit their website.

This article was originally published by the National Stem Cell Foundation. Click here to view the original article.

About the Monash Biomedicine Discovery Institute
Committed to making the discoveries that will relieve the future burden of disease, the Monash Biomedicine Discovery Institute (BDI) at Monash University brings together more than 120 internationally-renowned research teams. Spanning seven discovery programs across Cancer, Cardiovascular Disease, Development and Stem Cells, Infection, Immunity, Metabolism, Diabetes and Obesity, and Neuroscience, Monash BDI is one of the largest biomedical research institutes in Australia. Our researchers are supported by world-class technology and infrastructure, and partner with industry, clinicians and researchers internationally to enhance lives through discovery