Short summary

In daily clinic, metastatic colorectal cancer patients receive the standard treatments in two or three lines with no other options for targeting the cancer. In this particular setting we want to explore, if previously used antineoplastic drugs can still benefit the patient if rechallenged. We also want to investigate, whether drugs approved for other cancer types may benefit specific colorectal cancer patients. For that purpose we will use tumorspheres from individual patients to select drugs that may have clinical activity.

Rationale

Chemotherapy treatment of cancer remains a challenge due to the molecular and functional heterogeneity displayed by tumors originating from the same cell type. The pronounced heterogeneity makes it difficult for oncologists to devise an effective therapeutic strategy for the individual patient. One approach to improving treatment efficacy is to test the chemosensitivity of cancer cells obtained from the patient's tumor prior to treatment initiation. 3D culture represents a promising method for modelling of patient tumors in vitro. Preliminary studies have shown that colorectal cancer cells isolated from patient derived biopsies can be cultured as spheroids with a high success rate and remain viable for at least 10 days. Furthermore, chemosensitivity screening using spheroids from different colorectal cancer patients has demonstrated individual response profiles. 

Description of the cohort

Adult patients will be screened for inclusion if they have progressive metastatic colorectal cancer and have been exposed to, or are not considered candidates for, available therapies including fluoropyrimidine-, oxaliplatin- and irinotecan-based chemotherapies, anti-VEGF agents and, if RAS/RAF wild-type, anti-EGFR agents.

Data and biological material

We will collect demographic data, treatment and outcome data. Biopsy from a metastatic site will be stored in a biobank together with serial blood samples.

Collaborating researchers and departments

Universitätsklinikum Hamburg-Eppendorf

• Priv.-Doz. Dr. med. Andreas Block, MBA

• Consultant Lone Nørgård Petersen, PhD

Department of Oncology, Aalborg University Hospital

• Consultant Mette Nytoft Yilmaz

• Professor Ole Thastrup