Predicting patients response to preoperative chemo-radiotherapy for rectal cancer
Noam Auslander (UMD Student), Ruppin (UMD), Ried (NCI)
Rectal carcinomas account for approximately 20% of all colorectal cancers. Patients with stage II and III rectal carcinoma are treated with chemo-radiotherapy (CRT) before surgery to reduce the rate of local recurrences. However, not all patients respond equally well to CRT, with response ranging from complete response, i.e., no tumor cells left, to primary resistance. Clearly, accurately predicting the response to CRT before treatment commences would be immensely useful: patients whose tumors are resistant could either be treated with other regimens, or by surgery alone. Alternatively, patients with a predicted complete response and having other comorbidities might be spared surgery. Our goal is to build a predictor that will predict response to CRT based on the molecular data characterizing the tumor of each individual patient, spanning its gene expression, single nucleotide polymorphism and microRNA data. This analysis will also reveal the set of discriminating genes and accompanying molecular features that play a key role in modulating the response to CRT in rectal cancer. This will advance our understanding of the biological mechanisms behind resistance to chemo-radiotherapy in rectal cancer and may lead to new targets whose inhibition may mitigate this resistance.