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30th January 2020 Latest News Bowel Cancer

Preventing bowel cancer spread


Armed with THRF funding, Dr Kevin Fenix explains his promising bowel cancer research.

Did you know that in half of all bowel cancer diagnoses, the cancer will spread to the liver? Sadly, once this happens it is extremely difficult to treat, and most people who lose their lives from bowel cancer do so because it has spread to the liver.

We recently caught up with bowel cancer researcher Dr Kevin Fenix from the Basil Hetzel Institute (BHI), who is investigating a group of immune cells that could help predict whether a patient’s bowel cancer is likely to spread. Armed with funding from THRF through an Early Career Fellowship, he explains his work to save the lives of people living with this silent cancer.

Tell us about your research?

At present there are no effective tools to predict whether a patient’s bowel cancer will spread to the liver (liver metastasis). When this happens, it unfortunately increases the patient’s mortality rate from 30 per cent to 70 per cent, plus patients who undergo surgery to remove the cancer from the liver have a 90 per cent chance of the cancer redeveloping. So there is an urgent need to improve diagnostic markers and identify improved treatments that can prevent the spread of bowel cancer to the liver and treat liver metastasis.

During my Fellowship I have analysed patient sample data of approximately 350 bowel cancer patients from Australia and New Zealand. I have discovered that the presence of specific immune cells called Tissue-Resident T Cells can predict a bowel cancer patients’ risk of liver metastasis and survival. Furthermore, I have been studying the biology of these cells to determine their potential to be used as an immunotherapy target for bowel cancer patients.

How can this discovery improve patients’ survival rates?

There are two key points on how this discovery could impact patient survival. First, as a potential biomarker, my data suggests that identifying these cells in the presence of bowel cancer patients’ tumours may indicate a patient’s risk of the cancer spreading within the next five years.

This information is very valuable as it identifies patients who would need closer monitoring even after successful treatment of their primary bowel cancer.

Secondly, by understanding the biology of these cells, I aim to determine if they promote the spread of cancer. If proven, this makes them a target for new bowel cancer treatments.

What are the next steps?

The overall aim of my research is to find new ways to help bowel cancer patients. I hope to generate a powerful new screening method that helps oncologists identify which bowel cancer patients are susceptible to developing liver metastasis. I am also working on confirming if Tissue-Resident T Cells can potentially be targeted to develop new approaches to treat bowel cancer liver metastasis.

How far has bowel cancer research come in the past 10 years?

Bowel cancer is still a major problem not only in Australia but worldwide. However, there have been many significant improvements over the last 10 years to the management of bowel cancer. One of these is free screening offered by the Australian Government. If caught early, bowel cancer has a survival rate of over 90 per cent.

Current research is focused on finding new treatments for patients who have developed progressed bowel cancer that has spread, which to date is still a challenge.

With funding from THRF, you recently established the South Australian Liver Tissue (SALT) Biobank. How will this aid your research?

SALT is a tissue biobank consisting of liver tissue containing bowel cancer tumours. An important feature of these tissues is that they represent patients who have undergone successful liver resection, which is currently the only therapeutic treatment for liver metastasized bowel cancer.

Of these patients, about 70 per cent of them will redevelop this disease and unfortunately, we don’t know who is at risk of reoccurring liver metastasis.

By generating SALT, we hope to address this issue by investigating if there are unique biomarkers found in patients who have relapsed from those who didn’t. We initially are collecting patient samples from 2005-2010, this is important as these cohort of patients will contain valuable long-term clinical information that will allow us to identify relapse vs non-relapsed patients.

SALT will also have a second phase, a cohort from 2010-current. There are two benefits from this; firstly, it greatly increases the number of samples SALT contains and secondly, SALT will reflect changes that may happen in the management of bowel cancer treatments in the future.

Once we have the first cohort of SALT, we will begin to analyse if the biomarkers we have previously found is truly effective in identifying at risk patients.

How are you collecting the tissue samples?

The generation of SALT is only possible through a strong collaboration between our team at the BHI (the surgical science research group led by Professor Guy Maddern) and SA Pathology (who store these tissue samples). So far, we have been able to collect tissue samples from the Royal Adelaide Hospital, The Queen Elizabeth Hospital and Flinders Medical Centre.

Is this the only Biobank like this in South Australia?

Yes, the reason why we started this biobank is because there is no similar resource available in South Australia. There are similar biobanks available interstate/abroad. By creating SALT, we also hope to contribute in large multi-centre studies that may also be interested in finding biomarkers for liver metastasis relapse.

What are your research plans in the future?

I am truly grateful to The Hospital Research Foundation and its donors for supporting my research so far, helping to bring hope for bowel cancer patients most at risk.

In the future, I am interested in developing cell-based immunotherapies for cancer patients. While currently focused on bowel cancer, my work has potential to benefit a majority of cancer patients.