What is the science behind this project?

When someone is first diagnosed with bowel cancer, they are usually treated with surgery, often together with chemotherapy and sometimes radiotherapy. This initial treatment is often successful, but sadly in some people the disease returns in a resistant form that can’t be cured. These patients often have other chemotherapy drugs to help control their cancer. One of the drugs used at this stage is called irinotecan. But unfortunately it doesn’t work for everyone and can cause unpleasant side effects such as severe diarrhoea.

The trial, called PICCOLO, is investigating whether combining irinotecan with other drugs can improve its effectiveness and reduce its side effects.

One of the new combination treatments is with a drug called panitumumab. This is a new ‘smart drug’ so called because it is designed to specifically recognise and kill cancer cells. Patients entering the PICCOLO trial are tested for faults in a particular gene, which will help doctors know if panitumumab could work for their cancer. The team hope that using both drugs together, rather than irinotecan alone, will be more effective for these patients.

The second combination treatment will use a drug called ciclosporin. This is not a cancer-fighting drug itself, instead it changes the way the body excretes irinotecan. So doctors hope that giving both drugs at the same time will be just as effective as irinotecan alone, but will dramatically reduce side effects.

The researchers are inviting around 1,300 people with bowel cancer to take part in the trial, at over 50 hospitals all over the UK.

Looking to the future

At the end of the trial, the researchers will find out which treatment combination is best at prolonging life, relieving symptoms and reducing side-effects for patients.

But the team also want to make cancer treatment better tailored to individuals. So, in another branch of the study, our researchers will study samples donated by patients to help understand how the drug combinations work in different people. This should allow doctors in the future to predict which treatment will be most effective for individual patients.

For more information about bowel cancer you can visit our CancerHelp UK website bowel cancer pages. You can find out more about this trial on our CancerHelp UK clinical trials database.

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