Study Finds Potential Personalized Approach to Colorectal Cancer Treatment

Introduction

Researchers have identified a potential breakthrough in personalized cancer treatment. According to a study published in the Journal of Clinical Oncology, administering the anti-inflammatory drug celecoxib after surgery may improve disease-free survival in a subset of patients with PIK3CA-mutated stage III colorectal cancer.

Background

After primary treatment for stage III colorectal cancer, patients typically receive adjuvant chemotherapy intended to reduce the risk of cancer recurrence. However, in patients whose cancer recurs, treatment options are often limited. Prior research found that adjuvant anti-inflammatory prostaglandin inhibitors- including celecoxib- may improve survival in patients with PIK3CA-mutated colorectal cancer.

Studies Supporting Anti-Inflammatory Prostaglandin Inhibitors

In the Alliance 80702 trial published by Meyerhardt et al in JAMA in 2021, researchers enrolled 2, 526 patients between 2010 and 2015 and randomly assigned the patients to receive adjuvant chemotherapy with fluorouracil, leucovorin, and oxaliplatin (FOLFOX) for 3 to 6 months with or without celecoxib for 3 years. The patients who received celecoxib demonstrated a moderate benefit, but the results were not deemed statistically significant. In an observational study from 2012, published in The New England Journal of Medicine, researchers observed that patients with colorectal cancer who regularly used aspirin- a drug with a similar mechanism of action as celecoxib- had longer survival, but only if they had PIK3CA-mutated disease. Other observational studies conducted since then also supported this association.

Study Methods

Researchers performed whole-exome sequencing on 1,200 tumor samples from patients who participated in the Alliance 80702 trial. They discovered that 22% of the patients had PIK3CA-mutated colorectal cancer. Among these patients, those who received celecoxib experienced longer survival compared with the patients without PIK3CA mutations who received celecoxib.

Results

According to the research, the patients’ risk of dying was reduced by about 50% and by about 60% when excluding those who were using low-dose Aspirin. Disease-free survival was also improved but did not reach statistical significance.

Conclusion

“These findings strengthen a growing body of evidence suggesting that prostaglandin inhibitors could benefit a subgroup of patients with colorectal cancer. They suggest a potential personalized approach to additional therapy for patients with early-stage colorectal cancer,” explained senior study author Jeffrey Meyerhardt, MD, MPH, FASCO, Co-Director of the Colon and Rectal Cancer Center at Dana-Farber Cancer Institute.

“If these results are confirmed in other ongoing studies, it will be important for physicians to understand the genetics within the tumors of patients with early-stage colorectal cancer to determine which patients may benefit from celecoxib in addition to other standard treatments,” he concluded.

Disclosure

The research in this study was funded by the National Institutes of Health, the Alliance for Clinical Trials in Oncology Foundation, the Karen Guo Colon Cancer Fund, the Douglas Gray Woodruff Chair in Colorectal Research Fund, and the Stone Research Fund. For full disclosures of the study authors, visit ascopubs.org.

Disclaimer

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.

Long-Tail Keywords

Anti-inflammatory drugs in colorectal cancer treatment

Potential of celecoxib in colorectal cancer treatment

Improving survival in patients with PIK3CA-mutated colorectal cancer

Personalized approach to additional therapy for patients with early-stage colorectal cancer

The influence of genetics on determining appropriate colorectal cancer treatment

Whole-exome sequencing in cancer research

Originally Post From https://ascopost.com/news/june-2024/celecoxib-may-benefit-a-subset-of-patients-with-empik3caem-mutations/

Celecoxib May Benefit a Subset of Patients With PIK3CA Mutations ASCO Post