“Colon tumor is linked to old age”, according to oncologist Josep Tabernero.

The incidence of colorectal cancer improvement with healthy lifestyle habits but “no matter how well it is done, the tumor is linked to old age and the average age of onset is 67 years.” explains the director of the Vall d’Hebron Institute of Oncology (Barcelona), Josep Tabernero, who participates in Paris in the congress of European oncologists.

Tabernero, first author of a study that demonstrates the effectiveness of a new oral drug for advanced stage patients, admits that the new treatments are improving the survival rate, but reminds that it is still a very short time. 17% at five years in patients who have already developed metastases.

This oncologist recognizes that so far research on gastrointestinal tract cancer has been unsuccessful because the tumors are very complex, but this, he says, “is now changing.

He explains that the complexity in finding an effective therapy is due, in part, to the fact that cells in the digestive tract “to tolerate nutrients from food well and the coexistence of bacteria in the digestive tract” have an excess of tolerance in the defense mechanism against non-self proteins, and that reaction turns against the “turning a blind eye” to the malignant cells of tumors.

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That, says Tabernero, has to be taken into account when looking for treatments, and here the personalized medicine, new immunotherapy approaches and techniques such as liquid biopsy, which analyzes genetic alterations in the tumor in a blood sample, are essential.

700 patients

The FRESCO2 study, in which the Vall d’Hebron Oncology Department was the center that treated the most patients, was carried out in 700 patients with colorectal cancer who had already received all available treatments and were without alternatives, showed an increase in median survival from 4.8 to 7.4 months.

A modest advance but one that, in his opinion, opens the door to treatments for this tumor in patients orphaned of therapeutic options.

43,500 new cases in Spain

Colorectal cancer is the most frequent cancer considering both sexes, with an expected 43,500 new cases in Spain in 2022. Worldwide, the number of new diagnoses of this type of tumor amounts to 1,930,000.

Tabernero has presented at ESMO another study (Breakwater), where he has combined the chemotherapy first-line chemotherapy with specific treatment directed at the gene mutation (BRAF)which is observed between 8% and 10% of patients with advanced colorectal cancer.

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According to this expert, the effectiveness of this treatment directed is above 67%, a very high percentage, more so considering the poor prognosis of this group of patients.

For this oncologist, the future of colorectal cancer lies in early detection through screening that works by means of the fecal occult blood test. In the near future liquid biopsy will be incorporated into screening techniques.

The goal of all these advances, presented at ESMO, is to increase overall cancer survival by 2030 to 70% at five years, more than five points more than at present, and to achieve a reduction of at least 30% in preventable tumors.

In the case of colorectal cancer, Tabernero points out that risk factors can be reduced by leading a healthy life, with a healthy diet, low in fat and rich in fiber, limiting alcohol consumption, with exercise and no obesity but it is still a tumor that increases with tissue aging so the upward trend in late life will continue to be present.

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