A new drug trial for bowel cancer is underway across 22 NHS sites, testing the immunotherapy drug palupiprant on 140 patients, according to a report. The drug, which stimulates the body's immune response against cancer, is being trialled alongside standard chemotherapy and radiotherapy, according to a report. An earlier phase 1b trial of palupiprant eradicated cancer in 36% of participants after six months, according to a report.
In a separate trial, the immunotherapy drug pembrolizumab has shown remarkable results. A clinical trial of pembrolizumab before surgery kept 32 bowel cancer patients cancer-free for nearly three years, according to a report. After 33 months of follow-up, none of the 32 patients saw their cancer return, according to a report. The trial focused on patients with MMR-deficient/MSI-high bowel cancer, which accounts for 10-15% of stage two and three cases, according to a report. Patients received up to nine weeks of pembrolizumab before surgery, and 59% had no detectable signs of cancer after surgery, according to a report. Roughly a quarter of patients receiving standard surgery and post-operative chemotherapy would normally relapse within three years, according to a report.
I had a chat with the surgeon at my local hospital who said that because of the size and position of my tumour, he wouldn’t be able to operate without leaving me with a permanent colostomy bag and, although I was obviously willing to do anything to get rid of my cancer, it wasn’t ideal.
Dr Kai-Keen Shiu, chief investigator of the trial from UCL Cancer Institute and consultant medical oncologist at UCLH, said: "Seeing that no patients have experienced a cancer recurrence after almost three years of follow-up is extremely encouraging and strengthens our confidence that pembrolizumab is a safe and highly effective treatment to improve outcomes in patients with high-risk bowel cancers." He added: "What is particularly exciting is that we now may be able to predict who will respond to the treatment using personalised blood tests and immune profiling. These tools could help us tailor our approach, identifying patients who are doing well and may need less therapy before and after surgery versus patients at higher risk of disease progression or relapse who need additional treatment."
Patient stories highlight the dramatic impact of these treatments. According to Daily Mirror - Main, train driver Nick Cleworth, 48, had a golf ball-sized tumour eradicated by palupiprant without surgery. His father died from bowel cancer at age 48, according to Daily Mirror - Main. Cleworth had a 4cm tumour in his rectum that spread to nearby lymph nodes, according to Daily Mirror - Main. He described how his surgeon said he would not be able to operate without leaving him with a permanent colostomy bag, but after the trial, he felt much more positive.
My dad was 48 when he died from bowel cancer, the same age that I am now, so I’d always been vigilant about my health. But even though it was something that I knew might happen, the diagnosis still hit me extra hard. I couldn’t help but think about my dad and what he went through. It was a really difficult time.
Christopher Burston, 73, was diagnosed with stage three bowel cancer in February 2023, according to Daily Express - Health. He had three doses of pembrolizumab over six weeks before surgery, according to Daily Express - Health. According to Daily Express - Health, Burston described how the cancer had effectively melted away after treatment. Almost six in ten patients in the pembrolizumab trial had no signs of disease after treatment and surgery, according to a report.
Bowel cancer is the fourth-most common cancer in Britain, with around 46,600 new cases per year, according to a report. Bowel cancer kills almost 17,000 Brits each year, according to multiple reports. Rates of early-onset bowel cancer are rising, particularly in younger people, according to experts. Bowel cancer is increasing in under 50s, according to a report. A Lancet study found rates of early onset bowel cancer in those aged 25 to 49 are rising more sharply in England than in many other countries, according to a report. Since the early 1990s, bowel cancer in 25-49 year olds has risen by around 50%, according to a report. Experts believe poor diet, ultra-processed foods, obesity, and lack of exercise are playing a role in rising bowel cancer rates in younger people, according to experts.
I was much more positive coming out
The long-term survival rates for patients in the palupiprant trial beyond the initial six-month data remain unknown, as does whether the ARTEMIS trial results will be as promising as the pembrolizumab trial. The specific genetic or lifestyle factors driving the increase in early-onset bowel cancer are also not fully understood.
Seeing that no patients have experienced a cancer recurrence after almost three years of follow-up is extremely encouraging and strengthens our confidence that pembrolizumab is a safe and highly effective treatment to improve outcomes in patients with high-risk bowel cancers.
What is particularly exciting is that we now may be able to predict who will respond to the treatment using personalised blood tests and immune profiling. These tools could help us tailor our approach, identifying patients who are doing well and may need less therapy before and after surgery versus patients at higher risk of disease progression or relapse who need additional treatment.
The cancer was a very obvious lump high up in my bowel. I was told it was at stage three, and later learned that it could have been growing for years. This came as a real shock. I was, of course, aware that this was a very serious disease and that the outcome could be very nasty.
Over tea and biscuits after the colonoscopy, the nurses did their best to reassure me that treatment was possible and the outcome could be good.
As I understood the trial, the idea was that it could be possible to destroy the cancer using my immune system. This would be activated using a drug tuned to the genetic makeup of the cancer. The effect would be to reduce, or even eliminate, the need for chemotherapy after surgery.
I was told by Dr Shiu a few days later that the operation had shown that the cancer had effectively melted away. This was a wonderful relief and gave me hope that the cancer would not return and that further treatment would not be needed.
I have felt little effect from the treatment or surgery. I feel very lucky that I've reached the stage where my main problem is age rather than cancer or any illness. I am able to play guitar, tend my garden and walk the dog very much as before and I look forward to spending time with friends and family.