Helping to target treatments

Kirsten Ward-Hartstonge co-authored a University of Otago study on bowel cancer. Photo supplied.
Kirsten Ward-Hartstonge co-authored a University of Otago study on bowel cancer. Photo supplied.
A University of Otago pilot study has highlighted a new and potentially better way to identify some bowel cancer patients who face greater risks of cancer recurrence.

Other research has shown that New Zealand and Australia have the highest rates of bowel cancer incidence and death in the world.

The Otago study suggests that people with bowel cancer - also called colorectal cancer - that have a certain type of immune cell in their tumour may have increased survival rates.

Researchers at the Otago microbiology and immunology department found people with more ''effector T regulatory (Treg)'' immune cells present in their tumours were more likely to be disease-free for longer than those with fewer of the effector Treg cells.

The study involved 32 people with early second stage colorectal cancer, who were seen at Dunedin Hospital between 1995 and 2006.

These patients were followed up for more than five years and 13 people had a recurrence of their cancer over this time and 19 did not. The findings appear in the international journal Cancer Immunology, Immunotherapy.

Study co-author and PhD student Kirsten Ward-Hartstonge said it could be possible to measure immune responses to estimate which patients were likely to get their cancer back and should be given extra treatment.

This approach could help target existing therapies to ''people who really need them, rather than taking a more blanket approach'', she said.

About a quarter of patients who were considered ''low risk'' by current cancer stage assessment methods will eventually develop the disease again.

Such patients usually did not receive chemotherapy or radiotherapy because the risks and costs were thought to outweigh the benefits.

Using a new tool, called Immunoscore, to measure basic immune cells that had infiltrated into tumours, and also measuring more complex immune cells, the research examined which type of immune responses were associated with patient survival.

By measuring an individual patient's Immunoscore and ''effector Treg'' immune cells, it might be possible to ''more accurately identify patients at high risk of getting their disease back and treating them more effectively''.

It was ''satisfying'' to be part of a research team whose work provided a ''foundation for further studies that may improve the outcomes of colorectal cancer patients'', she said.

john.gibb@odt.co.nz

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