Colorectal cancer is rising sharply in adults under 50, prompting earlier screening guidelines and a wave of research into why. For advanced disease, immunotherapy works extremely well in the small group of tumors with mismatch-repair defects, and a new wave of targeted drugs is reaching patients with KRAS, BRAF, and HER2 changes.
What's actually going on in research
Studies are testing immunotherapy earlier, including before surgery for certain tumors, and combinations that bring it to a wider group of patients. Researchers are also evaluating circulating tumor DNA blood tests that can detect microscopic disease after surgery, less-invasive surgical approaches, and better treatments for liver-only spread of the cancer.
Immunotherapy expansion
Mismatch-repair-deficient colorectal cancers can melt away on immunotherapy alone, sometimes avoiding surgery entirely. Trials are extending these benefits to more patients.
Tumor DNA blood tests
Blood tests that detect tiny amounts of tumor DNA after surgery are being used to decide who needs chemotherapy and who can safely skip it. Results from large trials are arriving now.
Targeted therapy
New combinations for KRAS G12C, BRAF V600E, and HER2-positive colorectal cancer are showing real benefit. These were once considered untreatable mutations.
What to know before you search
Eligibility often depends on tumor stage, location (colon vs. rectum), specific genetic features (MSI status, KRAS, BRAF, HER2), and prior chemotherapy.
What types of trials are currently open
- Treatment trials — Testing new drugs or combinations in people with colorectal cancer to see if they work better than standard chemotherapy.
- Adjuvant trials — Testing whether adding treatment after surgery lowers the chance of cancer returning.
- Neoadjuvant trials — Testing treatment before surgery to shrink the tumor or sometimes avoid surgery altogether.
- Screening trials — Testing newer stool tests, blood tests, or colonoscopy strategies, especially in younger adults.
- Supportive care trials — Testing ways to manage neuropathy, bowel problems, and fatigue during and after treatment.
Recently added Colorectal Cancer trials
Understanding and Tailored Treatment of Low Anterior Resection Syndrome
The goal of this observational study is to learn why some patients develop low anterior resection syndrome (LARS) after colorectal cancer treatment. The study also aims to identify different subtypes of LARS and understand which patients may respond to specific treatments. The main questions it aims to answer are: * What physiological and imaging changes are associated with LARS? * How do patients with LARS differ from patients without LARS after colorectal cancer surgery? * Are there measurable differences between LARS, patients treated with organ-preserving chemoradiotherapy, and patients with fecal incontinence? Participants will: * Complete advanced physiological and imaging assessments related to bowel function * Be compared with four control groups: * patients without LARS after colorectal cancer surgery * patients treated with organ-preserving chemoradiotherapy * patients with fecal incontinence and urge fecal incontinence * Take part in a single study visit where all measurements are performed
Rectal Cancer Neoadjuvant Therapy-Real World Study
This study aims to utilise a real-world data platform to integrate multi-omics data-including radiomics, gut microbiota, pathological quality control and liquid biopsy-to construct a multidimensional predictive model for the efficacy of rectal cancer treatment following neoadjuvant therapy. By integrating multimodal data, the study aims to accurately assess the efficacy of neoadjuvant therapy and identify patients suitable for a 'watch-and-wait' strategy, thereby achieving tumour control and preserving organ function without the need for surgery. Furthermore, it seeks to provide scientific evidence for the efficacy of the 'watch-and-wait' strategy and the selection of optimal timing for surgery, whilst validating the model's effectiveness and assessing its clinical feasibility through prospective clinical trials.
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