Summary
Researchers in German have identified 115 genes that may help identify patients at increased risk of developing metastatic colorectal cancer. Of these genes, one gene, BAMBI, is more active in metastatic colorectal cancer than in local disease.
Analysis
The theory that finding more aggressive tumors early is only relevant if a treatment exists to alter the course of a more aggressive disease. We can now test people for genes that, if present, will lead to dementia - but at the present time, no therapy exists to alter the course of the disease process in these patients, and so exits the question of whether the test is useful.
Other genetic analyses of colorectal cancer have not yet translated to a survival benefit in patients (i.e. OncoType Dx by Genomic Health, Inc.). In order for this discovery to be useful, prospective, randomized clinical trials need to be undertaken in which patients with early stage local tumors are treated more aggressively. Only if these trials are positive does the discovery of BAMBI become relevant.
The ability to predict metastatic potential is not new. Interestingly, as a case in point, the data presented at ASCO 2009 for the OncoType Dx test in colorectal cancer validated the test - i.e. it accurately predicted those patients at increased risk of recurrence. However, the treatment alterations made in these patients did not translate to a change in outcome. In this era of financial awareness in health care - and particularly in oncology, such testing is unlikely to gain a foothold without outcomes data.
This author consults with leading institutions through GLG
Analyses are solely the work of the authors and have not been edited or endorsed by GLG.
