By Colorectal cancer is one of the most common cancers worldwide, and in Australia, it remains a leading cause of cancer-related deaths. However, advancements in medical research are transforming how colorectal surgeons and doctors treat this disease. Instead of relying solely on traditional chemotherapy and surgery, targeted therapies are offering more effective and personalised options for patients. From immunotherapy and precision medicine to innovative new treatment approaches, patients now have access to cutting-edge solutions that could improve survival rates and quality of life. For those diagnosed with colorectal cancer, early detection is still key. A colonoscopy in Melbourne performed by a female colorectal surgeon can detect pre-cancerous polyps before they develop into cancer. But when treatment is needed, the latest targeted therapies are changing the landscape of cancer care.
What is Targeted Therapy in Colorectal Cancer?
Targeted therapy refers to treatments designed to attack specific molecules involved in cancer growth and survival. Unlike chemotherapy, which affects both healthy and cancerous cells, targeted therapies are more precise, reducing side effects and improving outcomes.
1. Immunotherapy: Activating the Body’s Defence System
Immunotherapy works by boosting the immune system’s ability to recognise and destroy cancer cells. In colorectal cancer, checkpoint inhibitors—drugs that block proteins like PD-1 and CTLA-4—have shown success, particularly in patients with microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) tumours.
According to research, immunotherapy is highly effective – and in Australia, it is now a standard treatment for some advanced colorectal cancers. Drugs like pembrolizumab and nivolumab have been approved for specific cases, offering a potential alternative to chemotherapy for certain patients. However, not all colorectal cancers respond to immunotherapy, making precision medicine crucial.
2. Precision Medicine: Personalised Treatment Based on Genetics
Precision medicine takes a patient’s genetic profile and family history into account to develop customised treatments. Molecular testing can identify genetic mutations such as KRAS, NRAS, and BRAF, which influence how a tumour grows and responds to therapy.
- KRAS and NRAS Mutations: Patients with these mutations do not respond to certain targeted drugs like EGFR inhibitors (cetuximab and panitumumab). Instead, they may benefit from alternative approaches.
- BRAF Mutations: Around 10-15% of colorectal cancer patients have a BRAF V600E mutation, which tends to make cancer more aggressive. A combination of BRAF inhibitors and EGFR inhibitors has shown promising results.
- HER2-Positive Tumours: Some colorectal cancers overexpress HER2, making them responsive to HER2-targeted therapies like trastuzumab and pertuzumab.
With advancements in molecular testing, oncologists and colorectal surgeons can recommend treatments tailored to an individual’s tumour profile, increasing the chances of success.
3. Emerging Therapies and Clinical Trials
The future of colorectal cancer treatment is constantly evolving, with new drugs and combinations being tested in clinical trials. Some promising developments include:
- Tumour Microenvironment Targeting: Research is exploring ways to modify the environment around tumours to make them more vulnerable to treatment.
- Cancer Vaccines: Experimental vaccines are being developed to train the immune system to recognise and attack colorectal cancer cells.
- Liquid Biopsies: These blood tests detect circulating tumour DNA (ctDNA) to monitor treatment response and detect recurrence earlier than traditional imaging.
Australia has several world-class research institutions, such as the Peter MacCallum Cancer Centre and the Garvan Institute, leading studies into these innovative treatments. Patients are encouraged to discuss clinical trial options with their oncologist or colorectal surgeon.
Who Can Benefit from These Treatments?
Not all patients will be eligible for targeted therapy. Molecular testing is essential to determine whether a tumour has the genetic markers that respond to specific treatments. Patients with stage IV colorectal cancer may benefit the most, particularly those with MSI-H tumours, BRAF mutations, or HER2-positive disease.
For early-stage colorectal cancer, surgery remains the most effective treatment. Regular screening, including a colonoscopy in Melbourne, can help detect cancer before it spreads, increasing the chances of a full recovery. Patients who prefer a female colorectal surgeon or a male colorectal surgeon can discuss their options and treatment plans.
Looking Ahead: The Future of Colorectal Cancer Treatment
The landscape of colorectal cancer treatment is shifting rapidly, with immunotherapy, precision medicine, and new targeted approaches offering hope to patients. As research progresses, more personalised and effective treatments are becoming available, improving survival rates and reducing the impact of this disease.
Early detection remains critical, and a colonoscopy in Melbourne performed by a skilled female colorectal surgeon is one of the best ways to catch cancer in its early stages. With continued advancements, colorectal surgeons say the future of colorectal cancer treatment looks brighter than ever.