Clinical trials on Rectal cancer

Understanding Rectal Cancer

Rectal cancer is a formidable health challenge that originates in the rectum, the last several inches of the large intestine before the anus. This type of cancer is often mentioned in conjunction with colon cancer under the umbrella term “colorectal cancer,” but it has its unique characteristics and treatment approaches. The development of rectal cancer is frequently attributed to the growth of polyps, which can transform into cancer over time. Factors such as age, family history, a diet high in red or processed meats, smoking, obesity, and a sedentary lifestyle can elevate the risk of developing this condition.

Risk Factors and Symptoms

  • Age: Individuals over the age of 50 are at a higher risk.
  • Family History: A family history of colorectal cancer increases risk.
  • Diet: A diet high in red and processed meats can elevate risk levels.
  • Lifestyle: Smoking, obesity, and a lack of physical activity are significant risk factors.

Symptoms of rectal cancer can vary but often include changes in bowel habits, blood in stool, persistent abdominal discomfort, weakness or fatigue, and unexplained weight loss. Early detection through screening is crucial for effective treatment, as it can often lead to the complete removal of polyps before they develop into cancer or catch cancer at an early stage when it is most treatable.

Treatment and Prognosis

Treatment for rectal cancer typically involves a combination of surgery, radiation therapy, and chemotherapy. The choice of treatment depends on the stage of the cancer, its location, and the overall health of the patient. Advances in medical science have significantly improved the prognosis for rectal cancer patients, especially when diagnosed early. Multidisciplinary approaches involving surgeons, oncologists, radiologists, and other specialists are often employed to provide comprehensive care and improve outcomes.

Prognosis for Rectal Cancer: Understanding Long-Term Outcomes

Rectal cancer is a malignant growth that arises from the lining of the rectum, the final section of the large intestine. The long-term prognosis for rectal cancer varies significantly based on the stage at diagnosis, with early-stage cancers having a generally favorable outlook. Localized rectal cancer, where the disease is confined to the rectum, often has a higher survival rate compared to cases where the cancer has spread to distant organs. The five-year survival rate for localized rectal cancer can exceed 80%, while advanced stages with distant metastasis show a marked decrease in survival rates. Factors such as the cancer’s response to treatment, overall health, and the presence of certain genetic markers can also influence the prognosis. Regular monitoring and follow-up care are crucial for managing the long-term health in cases of rectal cancer. It is important to note that survival statistics are based on large groups of people and may not predict outcomes for individuals.

Complications in Rectal Cancer

When dealing with rectal cancer, there may be several complications that can impact daily life. One common issue is bowel obstruction, where the tumor blocks waste from passing, causing pain, bloating, and constipation. Another concern is bleeding within the digestive tract, which can lead to anemia, resulting in fatigue and weakness. In some instances, the cancer may create a hole in the wall of the rectum, known as a perforation, which is a serious condition that can lead to infection. Additionally, if the cancer spreads, it can affect other organs and lead to further health complications. These issues can significantly reduce quality of life, causing discomfort, stress, and a need for ongoing medical attention. Awareness of these potential complications is important, and any new symptoms should be communicated to a healthcare provider.

Treatment Methods for Rectal Cancer

In the management of rectal cancer, several non-clinical trial alternatives are recommended. Dietary adjustments, such as the increase of fiber intake and the reduction of red and processed meats, are beneficial. Regular physical activity is encouraged to maintain overall health. Pharmacotherapy options, including certain vitamins and supplements, may be advised by healthcare providers to support general well-being.

Modern technology offers innovative solutions, such as wearable devices that help in tracking fitness and dietary habits, potentially aiding in weight management and overall health. These methods, while not cures, can contribute to a comprehensive treatment plan. It is always recommended to consult with a healthcare professional before making any significant changes to one’s lifestyle or starting new treatments.

  • CT-EU-00053875

    Testing new treatments for Advanced Colorectal Cancer

    This trial is one of the first phases (called phase 1b) for testing treatments for patients with Stage IV Colorectal Cancer, a late stage of bowel cancer. The trial aims to find out how safe and well-tolerated three different drugs are: ATP128, VSV-GP128, and Ezabenlimab (BI 754091). The medicines will not be given randomly, but the doctors will decide the best option for each patient. ATP128 is a kind of protein that can stimulate the body to fight cancer. It is usually used together with BI 754091, a drug that can push the patient’s immune cells to be more active against cancer. On the other hand, the VSV-GP128 drug is a special kind of virus that can’t make a patient sick, but can help his body to recognize and destroy cancer cells. Three groups of patients will be set up: one had standard treatments before, and they didn’t work, one group had mild improvements after the first line standard treatment, and another group has only liver involvement. Those in each group will get different combinations of these three drugs.

    • Ezabenlimab/BI 754091
    • VSV-GP128- new modified virus used to boost the effectiveness of ATP128 against tumors
    • ATP128- new therapeutic cancer vaccine 
  • New study for safer rectal cancer treatment using ipilimumab, nivolumab and chemoradiotherapy

    This trial is about testing if a blend of two drugs, ipilimumab and nivolumab, can help people with rectal cancer when given with regular chemoradiotherapy (a blend of chemo and radiation therapy). The study tests if this new treatment is safe and if the body can handle it well. Doctors will keep an eye out for any new health problems (or worsening of existing ones) using detailed medical scales or systems used worldwide. Pictures of the affected area will be taken using advanced imaging technology (MRI), to see if the treatment helps shrink the tumor.

    • Nivolumab
    • Ipilimumab
  • Dostarlimab study for advanced rectal cancer patients

    This study is focused on a drug called Dostarlimab, which is being tested as a treatment for a type of advanced rectal cancer. The cancer in question is a type where the cells have a certain kind of damage and the body’s repair mechanisms aren’t working well (this is referred to as dMMR/MSI-H). This trial is specifically for patients who haven’t had any previous treatment for their cancer. The drug will be given to patients, and then the doctors will closely monitor them to see if the cancer disappears completely. If it does, patients will continue to be observed instead of undergoing traditional treatments like chemotherapy or surgery. The researchers want to find out if this drug alone can effectively fight the cancer. This trial will also keep track of other important outcomes. They will count the number of patients whose cancer does not get worse, recur, or lead to death three years after treatment. They will also count patients who have no signs of disease twelve, twenty-four, and thirty-six months after treatment.

    • Dostarlimab
  • Studying the effectiveness of durvalumab with therapy in rectal cancer

    This study examines a new treatment sequence for advanced rectal cancer. The goal is to test the new drug durvalumab as an addition to standard cancer treatments. Typically, treatment involves initial chemotherapy (including oxaliplatin, leucovorin, and fluorouracil), followed by a combination of more chemotherapy and radiotherapy. The trial drug, durvalumab, available in a 500 mg glass bottle for intravenous administration, is given every 4 weeks along with the other parts of the treatment. The combination of chemotherapy and radiotherapy is already standard, but this study is considering the use of durvalumab throughout the trial. The idea is to see whether the continued availability of durvalumab increases the effectiveness of the treatment, and researchers will continue to monitor patients for any side effects. Importantly, there will still be a deferral period before surgery to reduce the risk of complications. The aim is to see if durvalumab can improve the effectiveness of the treatment without causing serious side effects.

    • MEDI4736 (Durvalumab)