IMMitate
Research type
Research Study
Full title
Investigating the Immune Microenvironment during Total Neo-Adjuvant Therapy in Locally Advanced Rectal Cancer
IRAS ID
357853
Contact name
Paul Sutton
Contact email
Sponsor organisation
The Christie NHS FT
Duration of Study in the UK
7 years, 2 months, 0 days
Research summary
Presently within the UK over 16,000 people die from colorectal cancer each year. Despite advances in colorectal cancer screening, a large proportion of patients still present with advanced disease, which is either locally advanced cancer invading into surrounding structures, or metastatic cancer i.e. disease that has spread systemically to the liver, lungs, or peritoneal cavity.
In cases of advanced disease, patients are currently offered neoadjuvant therapy that seeks to reduce the size of the tumours allowing for patients to be offered curative surgery and for many the aim is to also avoid a permanent colostomy, where part of the large bowel is brought out through an opening in the abdominal wall.
More recently, radical (long-course) chemoradiotherapy and short course radiotherapy have been consolidated with systemic chemotherapy in an approach known as total neoadjuvant therapy (TNT). TNT is now the most common neoadjuvant therapy pathway for locally advanced rectal cancer in fit patients who are being treated with the intention of removing the cancer and providing patients with a cancer free prognosis.
However, response to treatment is both highly variable and unpredictable. Some patients exhibit an excellent response allowing for the opportunity for organ preservation, whereas other patients unfortunately progress or develop cancer in new sites during treatment.
Currently patients diagnosis relies on radiological imaging and pre-treatment biopsies, which does not enable clinicians to predict how a patient will respond to cancer treatments such as TNT. In light of this unpredictability there is a clear need to develop improved methods to determine an individual's treatment response to TNT to allow more personalised cancer treatment schedules.REC name
North West - Greater Manchester Central Research Ethics Committee
REC reference
25/NW/0169
Date of REC Opinion
16 Jun 2025
REC opinion
Favourable Opinion