A major international study of colorectal cancer called the ColoCare Study has received a five-year renewal and $10 million to fuel new innovations in colorectal cancer treatment. This next phase of the project will focus on developing new medical interventions based on earlier research findings from the ColoCare Study. It will also engage more patients in the research designed to yield insights into new tailored treatment approaches to critical unmet medical needs facing individuals with colorectal cancer.
The ColoCare Study is headquartered at Huntsman Cancer Institute (HCI) at the University of Utah (U of U). Originally founded in 2009, it brings together scientists and a diverse group of patients from several research institutions and geographic areas across the United States in addition to HCI: Cedars Sinai Medical Center, Los Angeles; Fred Hutchinson Cancer Research Center, Seattle; Moffitt Cancer Center, Tampa; University of Tennessee, Memphis; and Washington University, St. Louis; and a site in Europe: University of Heidelberg in Germany. The goal is to better understand the unique factors that impact survival and quality of life outcomes among people with colorectal cancer.
"I really value the numerous contributions of our team across the world, striving to conquer colorectal cancer together," says Neli Ulrich, PhD, MS, who leads the study. Ulrich is HCI’s chief scientific officer, executive director of the Comprehensive Cancer Center at HCI, and professor of population health sciences at the U of U.
Colorectal cancers start in the colon or rectum. According to the American Cancer Society, colorectal cancers account for 10% of the approximately 19 million new cancer cases diagnosed worldwide last year. In recent decades there have been major improvements in colorectal cancer survival. But alarmingly, trends in recent years show colorectal cancer incidence and mortality is on the rise in people under age 50 [early onset colorectal cancers]. Racial and socioeconomic disparities are prevalent among those most likely to die of the disease.
The ColoCare Study seeks to make a major impact in understanding how reduce suffering caused by colorectal cancers.
Insights From More Than 3,300 Colorectal Cancer Patients Worldwide
In its first five years, the study sites engaged more than 3,300 people diagnosed with colorectal cancers to participate in the research. "The ColoCare Study is critical in terms of helping to shed light on how we can reduce suffering due to colorectal cancer. We are studying many areas that can impact outcomes, including nutrition, physical activity, diet, and biomarkers that help improve tailoring of treatments," says Ulrich.
The international network is a key feature of ColoCare, providing insights from diverse patients across a variety of geographic areas. The ColoCare Study has been the basis of innovative research in nutrition, exercise, medication use, diet, quality of life, blood and tumor markers, and the gut microbiome, among many others. "In the first phase of our study, we discovered oxidative stress to be a key characteristic in people with colorectal cancers who are under age 50," says Ulrich. "Oxidative stress is a feature known to cause genetic damage and accelerate tumor growth. This information is critical to understanding that not all colorectal cancers are the same. We are working to advance these insights to the clinic to ensure younger people with colorectal cancers receive the most effective treatments for the unique characteristics of their tumors."
New Clues About Risk Factors for Aggressive Colorectal Cancers
Other insights from the first phase of the study include new clues about the relationship between inflammation and patients most likely to experience significant quality-of-life side effects, like cancer-related fatigue. Another avenue explored how high levels of physical activity among colorectal cancer patients improved outcomes. Researchers also learned that while obesity and colorectal cancer are closely related, the particular location of the fatty tissues in the body—rather than a measure like body mass index—was far more useful in terms of predicting potential negative outcomes.
A Focus on Recruiting Diverse Populations and Young Patients
Recruiting more early-onset cancer patients is a principal focus area of the next five years of funding. The team will also work to better understand the unique needs of patients who live in rural areas and have limited access to health care, and patients who are part of diverse racial and ethnic groups, including those who are Hispanic or Black.
The team will also continue to deliver insights using sophisticated techniques to understand how tumor biomarkers, meaning substances in the blood or tissue that can indicate characteristics of a tumor, can be used to inform outcomes. "We are working to better understand how we can inform patients about steps they can take to manage their risk," says Ulrich. "We have many questions we hope to answer, like how we can precisely tailor treatments for each patient. This new funding will allow us to continue to gain insights from the more than three thousand patients who generously agreed to volunteer to be part of this work, and to recruit new patients as well." Patients provide key insights about risk factors for colorectal cancer outcomes, including health behaviors, dietary patterns, and more.
The data collected by the ColoCare Study will be available to researchers worldwide. More than 70 research groups at other institutions have already been supported by ColoCare. The next phase of the study is geared toward continuing to gain insights about unique risks diverse populations face due to colorectal cancer, and in gathering insights into how interventions and treatments can be most effectively tailored for those patients.