Research into bowel (colorectal) cancer

Researchers are looking at the causes, diagnosis and treatment of bowel cancer.

All cancer treatments must be fully researched before they can be used for everyone. This is so we can be sure that:

• they are safe

• they work

• they work better than the treatments already available

Go to Cancer Research UK’s clinical trials database if you are looking for a trial for bowel cancer in the UK. You need to talk to your specialist if there are any trials that you think you might be able to take part in.

When in the trials database, click on the ‘recruiting’, ‘closed’ and ‘results’ tabs to see all the trials.

Some of the trials on this page have now stopped recruiting people. It takes time before the results are available. This is because the trial team follow the patients for a period of time and collect and analyse the results. We have included this ongoing research to give examples of bowel cancer research. 

Research into genes and bowel cancer

The risk of developing bowel cancer is higher in people who have a family history of bowel cancer. This can be caused by an inherited gene change. The risk increases depending on which gene is damaged or which part of the gene is damaged.

Researchers are learning more about genes and gene faults linked to bowel cancer. They are looking at blood and tissue samples from people who have had bowel cancer, as well as blood samples from people who haven't had cancer. They are also collecting information about family history.

Research into using blood samples to plan treatment

Researchers are looking at something called circulating tumour DNA (ctDNA). ctDNA are small pieces of DNA found in the bloodstream when cancer cells die. They take a sample of blood to look for ctDNA and to find specific changes (mutations) in the DNA.

Finding these changes may help to plan treatment. Also to assess how well treatment is working or see if a cancer has come back. 

A trial is looking at ctDNA in people with stage 2 or 3 colorectal cancer who have had surgery to try to cure their cancer. The researchers hope that by looking for ctDNA in the blood following curative surgery, they can use this information. It might help them to make better decisions on who might need further treatment. And also what the best treatment might be. 

Research into diet and exercise

We know that eating a high fibre diet, less red meat and processed meat can reduce the risk of bowel cancer. There is also strong evidence that a healthy weight and exercising lowers the risk of bowel cancer.

Researchers are looking at exercise programmes. They want to find out if following an exercise programme before and after bowel surgery, will help improve your recovery.

Research into aspirin and bowel cancer

Researchers are looking into whether drugs can prevent bowel cancer. They have looked at non steriodal anti inflammatory drugs (NSAIDS) such as aspirin to see if they can prevent bowel cancer developing. 

They are also looking into how aspirin affects cancer spread and whether it can stop cancer coming back after treatment.

Research into surgery for rectal cancer

A serious possible side effect of rectal cancer surgery is a leak from where 2 bits of bowel have been joined. This is called an anastomotic leak.

A research study wants to see if a new technology can help reduce this. They want to use a technology called Intraoperative Fluorescence Angiography (IFA) during the operation. This is a dye which is injected into the blood and makes it glow. It shows the surgeons the blood supply around the join which can help them make decisions during the operation.

Research into treatment before surgery

A trial looked at whether having chemotherapy and the drug panitumumab before surgery helps to stop bowel cancer coming back. Treatment given before surgery is called neoadjuvant treatment. 

The results so far show that chemotherapy before surgery for bowel cancer could be a useful treatment option. You can read more about this trial and the results.

More studies are now going to look at chemotherapy before surgery in younger and older patients. They will compare it to the standard to treatment.

Research into treatment for bowel cancer

Trials are looking at different chemotherapy drugs, either on their own or with other treatments such as targeted drugs and immunotherapy.

Targeted cancer drugs change the way cells work. They can block the signals that tell cells to grow. Immunotherapies can boost the body’s immune system to fight off or kill cancer cells.

Researchers are looking at giving these drugs on their own or with chemotherapy. So far this is mainly for advanced bowel cancer.

There are many types of targeted drugs and immunotherapies. For bowel cancer, researchers are looking at:

• drugs that block cancer blood vessel growth (anti angiogenesis treatment), such as aflibercept and lenvatinib
• monoclonal antibodies, such as panitumumab
• immunotherapies, such as pembrolizumab, durvalumab and dostarlimab
• a new virus treatment for rectal cancer called enadenotucirev (EnAd)
• drugs that target the KRAS gene change (mutation) such as sotorasib and adagrasib