- New treatment for patients with familial adenomatous polyposis (FAP) in the colon has been identified
- When drugs such as sulindac and erlotinib are given in combination can shrink the polyps and block the pathways from which cancer develops in FAP patients
- Familial adenomatous polyposis (FAP) is an inherited disorder that occurs in about 1 in 10,000 people
A new prevention treatment has been identified for patients with familial adenomatous polyposis (FAP) in the colon. They are at 100 percent risk of developing colorectal cancer if proper medical care is not given, reveals a new study.
The recent findings were published by researchers at Huntsman Cancer Institute at the University of Utah.
‘Drugs sulindac and erlotinib when given together can shrink the polyps and block the pathways from which cancer develops in patients with familial adenomatous polyposis (FAP).’
New Prevention Treatment for Familial adenomatous polyposis (FAP)
The findings of this study were taken a step further. The results show that the treatment has led to a near-complete blockade of cancer growth pathways in polyps that were isolated from FAP patients.
Further, the patient's active immune system aimed at destroying pre-cancerous polyps.
The findings were published in the journal Cancer Prevention Research.
FAP, an inherited disorder occurs in about 1 in 10,000 people.
FAP patients can develop hundreds to thousands of precancerous polyps in the large and small intestine of patients, and many choose to have surgery to remove their colon. However, they may still develop polyps in the small intestine.
In the previous HCI study, a two-drug combination of sulindac and erlotinib
has been identified. These drugs reduce the precancerous polyps in patients with FAP.
Scientists at HCI have further studied by conducting genomic analyses of polyps, which were collected from FAP patients who took part in the trial.
A comparison of gene expression in tissue from patients who received the treatment versus those who did not reveal that the drug combination led to a nearly complete blockage of pathways, which were involved in polyp growth.
Also, the activation of immune pathways in polyps from treated FAP patients have also been examined by scientists. The results show that the sulindac and erlotinib combination treatment can activate natural defense responses aimed at polyp eradication.
Deborah Neklason, Ph.D., who is an investigator at HCI and research associate professor of Internal Medicine at the University of Utah has led the study.
Neklason was surprised to see the active immune response to the polyps in these patients.
According to Neklason, "We thought treating the patients with this combination of drugs would stop the polyps from growing, and stop new polyps from developing. But what we actually saw was polyps shrinking. We saw them start to go away," said Neklason.
Need for Further Study
Don Delker, PhD, research assistant professor of Internal Medicine at the University of Utah oversaw the genomic analysis performed on the samples. "It was encouraging to see such a strong response in these tissues and the blocking of pathways from which cancer develops. We hope to use this information to help us find better treatments for patients with precancerous growths that can develop from these pathways."
Scientists are surprised by the results, and the potential for this information helps to address an unmet need in patients with FAP.
Identifying the optimal dosing of both the drugs is the next step, reveals the research team.
To achieve this, scientists and clinicians at HCI, The Mayo Clinic, and other Cancer Centers are planning to conduct additional clinical studies in FAP patients.