Project summary:

The DRIVEN project aims to create a method for tailoring the treatment of patients newly diagnosed with colon cancer, in particular for those with right-sided cancer which has been proven to be more severe than if on the left. The research team are reviewing scan results using a novel staging method called CT TDV which is more effective than a normal CT scan in grading cancer. Biopsies of over 100 patients are also being investigated and both sets of results will be compared with the surgery that was performed and the patients’ progress to create a future frame of reference for treating new colon cancer patients.

More detail:

The DRIVEN project aims to create a method to personalise the surgical and medical treatment for individuals newly diagnosed with colon cancer.

When someone is diagnosed, decisions regarding their prognosis, treatment pathways (eg. chemotherapy) and the extent of surgery required are informed by whether the cancer is on the right-hand side or not.  Although it has been proven that colon cancer detected on the right-hand side is more severe than on the left-hand side, some right-hand side cancers are over-treated with more aggressive surgery than necessary, and some left-hand cancers are under-treated. 

At present there is no reliable means to risk stratify patients with right-sided bowel cancer before they are operated on. This means that there is no opportunity to change the surgical approach based on prognosis, and no reliable means to identify patients who may benefit from chemotherapy before having surgery.

DRIVEN seeks to develop a risk stratification method for patients with right-sided bowel cancer.  Knowing ahead of surgery whether a patient is likely to have a good or poor prognosis will make it possible to tailor treatment to the individual.  Patients considered to be at higher risk can be offered more extensive surgery, and/or chemotherapy beforehand, if appropriate. 

The DRIVEN project is a collaboration between St Mark’s Hospital, The Royal Marsden Hospital and the Institute of Cancer Research. These three institutions are committed to improving the quality of bowel cancer surgery and have a track record in leading trials, the outcomes of which have been adopted internationally.  The involvement of surgical, radiological and pathological experts at multiple centres of excellence means the information-sharing potential of this project is significant. 

The research programme has two key components:

• Pre-surgery CT scans are being re-evaluated using a novel staging method called CT TDV which is more effective than a normal CT scan to grade cancer
• The pre-operative biopsies of over 100 patients of the Royal Marsden and St. Mark’s are being investigated

These scan and biopsy results will be compared with both the surgery performed and each patient’s progress to create a frame of reference for the future treatment of right-sided colon cancer based on an individual patient’s risk, helping to improving the outcomes for colon cancer patients.

This summary has been adapted by 40tude from a more detailed project overview provided by Riyah Talati and Nicola Hodges of St. Mark’s Hospital.  Nicola is the clinical research fellow leading the St. Mark’s component of this project, which is part of a wider Marsden Portfolio project.