Helping doctors treat advanced colorectal cancer
The EU-funded REVERT project has developed an AI-based decision support system (DSS) to help clinicians find the best treatment combination for individual patients with mCRC. The DSS is currently being tested in a clinical study carried out at six medical oncology units in three European countries. According to the European Cancer Information System, colorectal cancer is the third most diagnosed cancer in men (after prostate and trachea, bronchus and lung (TBL) cancers) and the second most diagnosed cancer in women (after breast cancer), accounting for 13 % of all new cancer diagnoses in the EU in 2022. It is also the second biggest cause of cancer death in men (after TBL cancer) and the third in women (after breast and TBL cancers), responsible for 12.3 % of EU cancer deaths in that year. When colorectal cancer metastasises, cancer cells from the colon or rectum spread to other parts of the body, such as the liver, lungs or lymph nodes. In some cases, mCRC patients can undergo curative resection – surgery to remove all malignant tissue. However, mCRC usually has a dismal prognosis and treatment is for the most part palliative in nature, since the vast majority of patients have unresectable mCRC and less than 20 % survive beyond 5 years in Europe.
A system to support clinical decisions
To create a DSS capable of assisting clinicians in identifying the most suitable treatment combinations for unresectable mCRC patients, REVERT collected colorectal cancer data from a wide range of sources: clinical databases, UK Biobank data sets and real-world data. Adopting a personalised medicine approach, they developed an improved innovative model of combinatorial therapy that identifies the most efficient and cost-effective therapeutic intervention for patients with unresectable mCRC. “The consolidation of the REVERT database (RDB) – hosted on an Amazon Web Services bucket – was a prerequisite for the development of a DSS to determine the optimal treatment option for individual patients, which is now being tested in a clinical trial involving patients with unresectable mCRC,” reports an article posted on ‘Open Access Government’. The clinical trial is being held in six medical oncology units in Spain, Italy and Romania. According to clinical trial coordinator Prof. Mario Roselli of REVERT project partner University Hospital Tor Vergata, Italy, the clinical study aims to further individualised treatment for unresectable mCRC patients by determining the most effective therapeutic option on a case-by-case basis. “In addition to the DSS devised for the clinical trial, the ML-based 7-Gene Algorithm, which consists of mutation profiles of seven genes (KRAS, BRAF, ERBB2, MAP2K1, TSC2, TP53, and APC) showed a statistically significant accuracy as a classifier to distinguish between patients who responded to first-line chemotherapy and those who did not,” reports the article. “Further studies are currently involving next-generation DNA and RNA Sequencing, which are being used to perform drug sensitivity analyses and identify novel potential drugs for improved predictive models for tailored treatment of mCRC.” REVERT (taRgeted thErapy for adVanced colorEctal canceR paTients) ends in December 2024. For more information, please see: REVERT project website
Keywords
REVERT, cancer, unresectable, colorectal cancer, mCRC, patient