Does Radiation Change Rectal Cancer Tumor DNA for Better Chance of Survival?

THIS STUDY UTILIZES THE DHF BIOREPOSITORY Principal Investigator: David Escobar, MD, PhD, Assistant Professor of Pathology (Gastrointestinal Pathology), Northwestern Medicine, Northwestern Feinberg School of Medicine The second leading cause of death in the U.S., colorectal cancer diagnoses have skyrocketed in recent years, especially in younger people in their 30s and 40s, for reasons that are still under investigation.  In 2023 over 153,000 Americans will be diagnosed with colorectal cancer, with 30% of those diagnoses being rectal cancer. During the past 20 years, treatment for locally advanced rectal cancer has evolved from traditional chemotherapy, radiation and surgery, and then more chemotherapy, to a new standard of care known as total neoadjuvant chemoradiotherapy (TNT). This more personalized medicine strategy initially involves only chemotherapy and radiation. Many patients undergoing TNT do not need surgery—preserving crucial organs and normal function, as well as maintaining quality of life. Dr. David Escobar speculates that the radiation used in TNT uniquely sensitizes the tumors of these patients, leading to higher cancer cure rates without surgery in contrast to less successful, risker traditional therapy. This year’s grant from DHF will advance his team’s work investigating how radiation therapy may change the genetics of patients’ tumor cells by making the cells more responsive to cancer killing strategies like TNT. If this hypothesis proves to be true, further research could be launched, on strategies like immunotherapy, to help patients who still have residual cancer after TNT in avoiding colorectal surgery and the often serious, life-changing complications that come with...

p53 Mutation Spectrum (Occurrence) and Load (Genotype Damage) in Ulcerative Colitis

Principal Investigator: Guang-Yu Yang, MD Chronic inflammation is an important risk factor for cancer. Patients with ulcerative colitis (UC) face a significantly increased risk of developing colorectal cancers. Damaged DNA and genetic alterations can be caused by the inflammatory process. Identifying crucial inflammation-associated molecular events offers potential targets to predict and prevent cancers. Missense p53 mutations are one of the most common and earliest molecular events seen in UC-associated carcinogenesis. Yet little is known about the evolution of p53 mutations during the long-term course of UC and whether targeting these mutations will have an impact on the long-term cancer risk in patients with UC. Employing a next-generation sequencing approach, Dr. Yang’s study aims to determine the mutation spectrum and load of the p53 gene in this patient population. The researchers intend to identify whether specific p53 mutations are critical in driving UC-induced carcinogenesis, and to evaluate its role as an efficient biomarker for predicting the risk of cancer development in UC...