Researchers belonging to three groups of the CIBER for Cancer (CIBERONC) -coordinated by Alberto Muñoz, Alfredo Carrato and Atanasio Pandiella– have participated in a study published in Molecular Cancer in which they have determined a set of genes associated with changes in fibroblasts / exosomes that predict with greater precision what will be the evolution of patients with colon cancer.
Colon cancer and evolution in patients
Colon cancer is the most frequent malignant tumor in Spain and constitutes one of the main health problems of the population due to the large number of deaths it causes throughout the world. Currently, clinical data are available to help evaluate the prognosis and evolution of patients. However, these data are not patient and tumor specific and do not accurately and individually predict the course of the disease. Thus, biomedical research is essential for the identification of new markers based on specific cellular and molecular processes of each tumor.
Exosomes, transport of information between cells
The reasons why some patients develop more aggressive forms of the disease and others do not are not well understood. However, the available scientific evidence shows that, within the tumor, other cells and components, which we call tumor stroma, coexist with tumor cells, with very different characteristics and functions from which some advantages derive for the tumors. Tumor cells themselves and therefore are responsible, at least in part, for the aggressiveness of tumors. The communication that occurs between the different components of the tumor stroma occurs, among other mechanisms, through exosomes. These exosomes are small microvesicles that are secreted by the different cells that make up the cell stroma and that transport information from one cell to another, modifying the behavior of the recipient cell.
Improve survival and quality of life of patients
Working in this area of research, and by studying the most frequent cell type of the stroma, the fibroblasts associated with tumors, and the exosomes secreted by them, our group has determined a set of genes associated with the changes in these fibroblasts / exosomes that predict, with greater precision than current clinical parameters, what will be the evolution of patients with colon cancer.
In turn, it is noteworthy that the genes described better predict the behavior of the disease in those patients in whom the disease is already locally advanced (stage III patients). This group of patients is prone to developing relapses of the disease, which is why they are treated with chemotherapeutic agents that have previously shown a benefit in the survival of patients in general.
However, it has been described that there is a group of these patients with stage III colon cancer that has a low risk of relapse and has better survival, even with shorter chemotherapy treatments and, therefore, with less accumulated toxicity. . The problem is that in daily clinical practice there is not enough evidence for a better classification of stage III patients, so all of them are treated in a standard way with very similar treatments.
“The data of this study present a clear clinical applicability since they could lay the methodological bases to identify which are the patients with greater or lesser probability of relapses or aggressive disease and therefore be able to develop therapeutic strategies according to the individualized processes of each patient thus avoiding unnecessary overtreatments and toxicities, with the ultimate aim of improving survival and quality of life for patients with colon cancer “, the researchers say.
Among the CIBERONC researchers participating in the study are Cristina Galindo-Pumariño, Alfredo Carrato, Alberto Ocaña and Cristina Peña.