Colorectal cancer is a research focus of greatest importance to us at the CRUK Scotland Centre as part of implementing our mission to address tumours that especially affect the Scottish population. Although colorectal cancer (CRC) has a high death toll in the UK overall, it is particularly prevalent in Scotland. We have established ourselves as one of the UK’s leading centres in this cancer type; with expertise spanning the breadth of CRC from prevention to treating late-stage disease.

Despite much research into CRC, there have been disappointingly few advances in the treatment of colorectal tumours in the past two decades. It remains the third most diagnosed cancer in the world and is the second highest cause of cancer-related death in Europe. Screening programmes have improved early detection, however, 50% of patients are still diagnosed with advanced metastatic disease leading to devastating outcomes. 

The Centre focuses – through prevention & early detection and improving survival - on the very early and late stages of CRC

 

The team, over the recent decade, has established multiple patient study cohorts and has a high activity around early-phase clinical trials. To date, between Edinburgh and Glasgow, we have collected an array of samples, including tumour probes, genetic data and biochemistry markers, from over tens of thousands of patients which are routinely accessed by the researchers across the Centre and our partner organisations. As tissue resources are a key part within our translational pipeline, we work to extend our existing collection, in particular, to include patient-derived organoids but also to gain deeper resolution within archival tissues.

Over the coming years, our ambition is to improve the national CRC screening programme in Scotland which is two-fold: to refine the screening strategy and to expand the landscape of agents used to counter tumour development. The CRC team brings together geneticist, epidemiologists, bioinformaticians, health economists, oncologists, clinicians and experts in disease modelling and metabolism. We will explore multiple predictors such as genetics, tissue markers, health & lifestyle variables to identify patients beyond conventional screening efforts such as the faecal immunological tests which is invasive, laborious and expensive. Secondly, modelled on previous successes around vitamin D, we aim to develop a screening platform, supported by the Phenomics discovery initiative, spanning genetic based analysis, patient derived organoid, mouse models, that allows the systematic assessment of novel and conventional therapeutic agents – where research will be prioritised on metformin and aspirin.

The area of greatest clinical need within CRC, arguably is late stage disease, when the cancer has spread to other sites around the body. We strive to improve the management of metastatic CRC whereby our researchers are positioning activities on developing comprehensive profiles of liver metastasis, refining our existing suite of pre-clinical models, modelling disease progression and response to treatment and pioneering the trial of new therapies.

 

Collaborative landscape

The colorectal cancer team takes a highly collaborative approach and their research efforts are intertwined with multiple national and international consortia such as:

ACRCelerate – CRUK Accelerator network for preclinical modelling of CRC

GECCO – Genetics and Epidemiology of Colorectal Cancer Consortium

INCISE – network to transform bowel cancer screening in the UK

RadNet Glasgow– CRUK Radiation Centre of Excellence made rectal cancer one its cancers to fous on

S:CORT – Stratification in Colorectal Cancer

SCOT trial – Study of adjuvant chemotherapy in colorectal cancer