Impact Spotlight: The CO.17 trial

A breakthrough in advanced colorectal cancer treatment

In the early 1990s, there was only one treatment available for advanced colorectal, or bowel cancer, the chemotherapy drug 5-fluoracil. At the GI Cancer Institute and around the world, researchers knew there was a need for more options for patients, especially because bowel cancer affected 9,662 people every year and its incidence was growing. By the end of the decade, new forms of chemotherapy had become available, notably oxaliplatin and irinotecan, which began to improve outcomes for patients.

As part of this wave of new research, we conducted the CO.17 trial led by Professor Chris Karapetis. This research was conducted in collaboration with the Canadian Clinical Trials Group. It studied the effectiveness of the drug cetuximab – and found that this new treatment increased survival for some people with advanced colorectal cancer.

When the results of the trial were analysed, another key insight was discovered. The patients who survived were those whose cancer did not carry a gene mutation called K-RAS. This strategy of selecting treatment for patients based on genetics was an important step for the development of personalised medicine.

“The results of our analysis allowed a more personalised treatment approach, and can spare patients who are unlikely to benefit from cetuximab treatment from receiving an ineffective therapy,” says Professor Karapetis.

“This pioneering work led to many other important international studies involving cetuximab and related antibody treatments in colorectal and other types of cancer.”

The CO.17 trial was a gamechanger. As well as more research into the use of cetuximab as a treatment, the results of CO.17 also led to a change in international treatment guidelines, which now recommend cetuximab for patients with advanced colorectal cancer and the right genetic profile.

Thank you to everyone who was involved in this trial especially the dedicated patients and their families who took part to improve our understanding of treating this disease.


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