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Current lines of research into colorectal cancer fall into three groups:
Immunotherapy. Immunotherapy is a new strategy in the fight against metastatic, microsatellite-unstable colorectal cancer (5% of all cases). It involves the intravenous administration of a biological therapy that enhances the immune system’s own capacity to recognise and destroy the tumour.At the time of writing, there are several clinical trials currently assessing the efficacy of immunotherapy as a therapeutic strategy in colorectal cancer, both in microsatellite-unstable and microsatellite-stable cancers.
Targeted molecular therapy. Targeted molecular therapy is a new class of biological drugs, for example antiangiogenics and anti-EGFR antibodies, designed to interact with specific targets on tumour cells. BRAF inhibitors provide another example of targeted molecular therapy. BRAF inhibitors in combination with anti-EGFR antibodies and chemotherapy are currently demonstrating signs of efficacy in patients with BRAF-mutant metastatic colorectal cancer (15% of all cases). However, BRAF inhibitor monotherapy is ineffective in such cases.
Liquid biopsy(circulating tumour DNA). A liquid biopsy analyses genetic tumour material found in the patient’s blood (circulating tumour DNA).
Various studies into liquid biopsies are currently underway. Some studies aim to detect which patients can benefit from adjuvant chemotherapy (postoperative intention-to-cure chemotherapy). There are also studies designed to monitor changes in the tumour biology observed in metastatic patients to discover whether a patient is resistant to a new therapy and so it needs to be changed.