A major study has revealed bowel cancer can be divided into four different diseases, with each one assigned its own biological characteristics. Scientists from the Institute of Cancer Research, London, looked at data from 3,443 patients with bowel cancer from all over the world.
The research will allow them to better treat each distinct type of bowel cancer and develop drugs that are better at targeting the disease. The study saw the scientists use mathematical algorithms that combined parameters including genetic mutations, gene activity, immune system activation, cell metabolism, cancer cell type and ability to invade neighbouring tissues to help them better group the disease.
The results, according to the study published in Nature Medicine, showed 87% of bowel cancers can be "robustly assigned to one of the four groups". One type – CMS4 – was often diagnosed late, when it has already reached stage three or four and was likely to spread. Patients who were diagnosed CMS2 often had better survival rates even if the cancer comes back.
Study co-leader Dr Anguraj Sadanandam, team leader in Precision Cancer Medicine at the Institute of Cancer Research, London, said: "Our study has identified four distinct types of bowel cancer, each with a definite set of genetic and biological characteristics, and some of which are more aggressive and more likely to be fatal than others.
"This could allow doctors to pick out those patients with more aggressive disease and treat them accordingly. Ultimately, it could lead to development of new molecular diagnostic tests to diagnose patients by their particular type of bowel cancer, and give them the most effective treatments for that type.
"Our work is a perfect example of the team science approach that is increasingly being used to tackle the biggest research problems – with collaborators compiling data from around the world to arrive at these new disease classifications."
Professor Paul Workman, chief executive of the Institute of Cancer Research, London, said: "Over the last decade there has been a major change in the way we look at cancer, with an increasing understanding that tumour types such as breast cancer, prostate cancer and now bowel cancer are actually multiple different diseases.
"Our researchers and colleagues around the world have analysed huge amounts of data on the genomics and biology of bowel cancers in order to arrive at this new classification. The findings will allow us to understand the behaviours and weaknesses common to each type of bowel cancer, and to use that information to predict how patients are likely to respond to current treatments and to design tailored approaches to therapy."