Early detection of recurrence
Approximately 80% of the patients with primary colorectal cancer undergo intended curative resection,
mostly patients with stage I-III disease, but also few patients with stage IV disease.
Neoadjuvant chemo- or chemo-radiation therapy and adjuvant chemo- and antibody-therapy
are offered to reduce the risk of recurrence.
- —, recurrence is observed among 35–40% of the patients who have been curatively resected
- Out-patient clinical follow-up with addition of endoscopy, imaging and few blood tests are offered to detect recurrence as early as possible.
- The value of such follow-up programs is still debated
- At present, recurrence is often detected at severe stages with dissemination to other organs, including liver, lungs and brain. Therefore, treatment of recurrent disease is far from always successful.
- Early detection of recurrence would improve the overall prognosis and lead to more surviving patients
Current results of research in early detection of recurrence
In collaboration with our partner, Professor Claus Andersen, Skejby Hospital (DK), it is shown
that methylation of DNA—from circulating tumor cells in blood—may be crucial for early detection of
Previous studies have shown that most patients with CRC have methylated DNA prior to surgery.
In most, the methylated DNA disappears after surgery, while at others some methylated DNA
still remains in the blood. Such individuals are at high risk of developing recurrence, as confirmed in subsequent studies.
Hence currently, a major study is being conducted wherein methylated DNA presented in blood after surgery
should be indicative of whether chemotherapy treatment is offered—regardless of the initial stage of the disease.
to collaborate internationally with academics and biotech companies in developing a blood-based testing system that could be useful to identify recurrence at an early stage
—leading to options of renewed intended curative treatment.