PRoSecCo

Protocol Title

Predicting ChemoRadiotherapy Sensitivity in Rectal Cancer Organoids (PRoSecCO)

Purpose of the Study

Bowel cancer is the third most commonly diagnosed cancer in Australia and is a leading cause of cancer related death. Rectal cancers are located in the lower region of the bowel and account for over one-third of all bowel cancers. Standard treatment for locally advanced rectal cancer is chemotherapy plus radiotherapy (chemoradiotherapy). Approximately 20-30% of these patients respond very well to this therapy, but a significant proportion of patients do not receive benefit and often endure harmful side-effects. Personalisation of patient treatments based on prediction of therapy response could improve patient management. Identification of patients likely to have successful ablation of their cancer by chemoradiotherapy could mean surgery can be avoided, whilst identification of patients unlikely to respond could mean that potentially harmful radiation is avoided and alternative therapeutic approaches could be provided earlier.

It has recently become possible to grow individual patient’s cancer cells in the laboratory. These 3-dimensional models faithfully mimic the biology of the original cancer and are called ‘organoids’. The development of patient-derived organoid models has transformed the study of cancer biology. Laboratory based drug testing of these organoids has been shown to predict clinical response to therapy. In this study, we plan to test the feasibility of collecting biopsy tissue from patients with locally advanced rectal cancer, growing this tissue in the laboratory and testing the sensitivity of the cells to chemoradiotherapy. We will then compare the outcome of our laboratory findings with the clinical response in the patient. This will be the first study of its kind in Australia. If we are able to consistently establish organoid models and test chemoradiotherapy sensitivity in a rapid timeframe, this will pave the way for a future clinical trial where the choice of patient therapy is made based on this laboratory test. We hope that the increased use of this personalised approach to therapy will ultimately improve patient outcomes by accelerating access to therapies most likely to provide benefit, whilst limiting procedures and therapies that may produce adverse effects in the absence of benefit.

PRINCIPAL INVESTIGATOR

Professor Vicki Whitehall

Contact Email

Please contact Dr Sarah Hayes (sarah@gicancer.org.au) if you have questions regarding this study.

Funding

2022 AGITG Rectal Cancer Research Grant