Cancer treatment is becoming more individualised, with therapies tailored to the patient. A recent UK-led study known as the NEOPRISM-CRC trial is a good example of this shift and could eventually change how some bowel cancer patients are treated.
The trial focused on a specific type of bowel cancer and tested whether giving immunotherapy before surgery could produce better results than the more traditional route of surgery followed by chemotherapy.
Here, we’ll explore how immunotherapy works, why the NEOPRISM trial has attracted so much attention, and what these findings could mean for the future of bowel cancer treatment.
The role of immunotherapy in cancer care
Most people are familiar with chemotherapy, which works by targeting rapidly dividing cancer cells. Immunotherapy works very differently.
Instead of attacking the cancer directly, immunotherapy helps the body’s own immune system recognise cancer cells and destroy them. You can think of it as removing a disguise that allows cancer cells to hide from the body’s natural defences.
This approach has already transformed treatment for several advanced cancers, but researchers are increasingly exploring whether it can be used earlier in the treatment journey, before surgery takes place.
A trial involving colorectal cancer patients
The NOPRISM trial focused on patients with a particular type of bowel cancer known as mismatch repair-deficient (dMMR) colorectal cancer.
These cancers have difficulty repairing damage to their DNA, causing them to accumulate large numbers of genetic changes over time.
Those changes make the cancer cells less recognisable by the immune system. Once immunotherapy removes these barriers, the body can launch a much stronger attack against the tumour.
Researchers found that a short course of immunotherapy before surgery produced an exceptional response in many patients. Perhaps most encouragingly, those patients remained free from cancer recurrence during the three year follow-up period.
One of the most promising aspects of the study is the possibility that some patients may eventually be able to avoid chemotherapy after surgery.
The findings also show the growing importance of testing tumours for specific genetic characteristics. Increasingly, treatment decisions are based not only on where a cancer is located, but also on its biological behaviour.
The future of bowel cancer treatment
Surgery remains the cornerstone of bowel cancer treatment for many people. The study offers a glimpse into the future of cancer care. Rather than every patient receiving broadly similar treatments, doctors are becoming better at identifying which therapies are most likely to work for each individual tumour.
At the Warwick Bowel and Hernia Clinic, we closely follow developments like these because they represent genuine progress in bowel cancer care. Studies such as NEOPRISM show how rapidly treatment is evolving and how research is helping to deliver more personalised, more effective, and potentially less burdensome care for patients.
To find out if you’re suitable for bowel cancer surgery, please get in touch to arrange a consultation.
