Treatment of Colorectal cancer can include surgery, radiation therapy, chemotherapy, and other targeted therapies, or a combination of these. Doctors who treat cancer choose treatments based on the state of the disease, and the particular condition of the individual.

Chemotherapy:

The use of drugs to kill cancer cells, usually by stopping the cancer cell's ability to grow and divide. For many years, 5-flouroucacil (5FU) plus leucovorin [IFL] was the only effective treatment regime. It had a median overall survival of 12 months. There have been recent advances to this program. The treatment, known as FOLFOX (5-FU with leucovorin and oxaliplatin), has helped increase average overall survival, and is now among a variety of chemotherapy options one offer. These treatments – surgery, radiation therapy, and chemotherapy - are often tried in combination with targeted therapies, as discussed below.

Targeted Therapies:

Targeted therapy is an approach that targets the cancer's specific proteins, genes, or the tissue environment that enable the cancer to survive. Increased knowledge of the mechanisms involved in mCRC indicates that there are a number of sub-types that have different pathology and which also react differently to different types of treatment. Many growth factors and receptors have been shown to work in a complementary and coordinated manner with the efficacy of established pathways to regulate mCRC (and other) tumor growth and angiogenesis (the formation of new blood vessels), suggesting that blockade of multiple growth factors and receptor pathways may be required to increase cancer therapies.

Epidermal Growth Factor Receptor Inhibitors:

This treatment can help to shrink and stabilize the growth of colorectal cancer by disturbing the process by which tumours develop. The two drugs available for this treatment - Cetuximab and Panitumumab - do not work as well for tumours that have specific gene mutation (changes) within a gene called KRAS. Therefore, for many people, this treatment is not a suitable option.

Anti-angiogenesis therapy:

This treatment focuses on stopping angiogenesis, which is the process of making new blood vessels. Because a tumour needs the nutrients delivered from blood vessels to grow, the goal is to effectively starve the tumour.

Multi-kinase inhibitor therapy:

The kinases are a family of proteins involved in many aspects of cell regulation and changes in regulation are involved in the formation and progression of cancer as well as being involved in tumour angiogenesis. Targeting this family of proteins can therefore affect the ability of the tumour to survive and to create new blood vessels. 

Regorafenib:

Regorafenib (REG) is a novel oral multi-kinase inhibitor that blocks the activity of several protein kinases, including those involved in the regulation of tumour angiogenesis, oncogenesis and the tumour microenvironment. REG is used for mCRC patients who have not responded to any other available therapy and have mCRC. Colofortell aims to discover predictive biomarkers which will allow selection of patients who will attain the greatest benefit from treatment – refer to "What will ColoForetell do?".