Cancer of the appendix differs from colorectal cancer after all

Share this article:

The same chemotherapy used for colon cancer is also used for cancer of the appendix, which is part of the colon, but this approach has proven to be largely ineffective. Now, gene expression profiling for appendiceal cancer has demonstrated that the disease is, in fact, quite distinct from colorectal cancer, and may require different treatment.

A rare malignancy affecting approximately 2,500 people per year in the United States, cancer of the appendix has the propensity to metastasize throughout the peritoneal cavity. Peritoneal metastases from appendiceal cancer and from colon cancer are both addressed with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC, in which heated chemotherapy is placed directly into the abdominal cavity at the time of surgery).

This approach shows great promise, according to Edward A. Levine, MD, chief of the surgical oncology service at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina, and coauthor of the gene expression profiling study, published in Journal of the American College of Surgeons. However, many HIPEC patients experience cancer recurrence.

In order to better predict oncologic outcomes, Levine and colleagues analyzed global gene expression in 41 tissue samples of peritoneal metastases (26 appendiceal and 15 colorectal) taken from persons undergoing HIPEC with complete cytoreduction and more than 3 years of follow-up. They found three distinct phenotypes, two of which consisted of predominantly low-grade appendiceal samples and one consisting of predominantly colorectal samples. Genetic signatures predicted survival of low-risk vs high-risk appendiceal cancer and low-risk appendiceal cancer vs colon primary cancer.

Having confirmed the unique biology of appendiceal cancer, Levine's team suggested that basing treatment for such lesions on colon cancer regimens may be unwarranted, and that a fresh therapeutic approach to cancer of the appendix is needed. The newly identified phenotypes could lead to more effective treatments for both diseases.

Share this article:
You must be a registered member of ONA to post a comment.

Sign Up for Free e-newsletters


What is this?

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Genitourinary Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Rare Cancers Regimens
Skin Cancer Regimens Drugs

More in Web Exclusives

Some aggressive cancers may respond to anti-inflammatory drugs

New research raises the prospect that some cancer patients with aggressive tumors may benefit from a class of anti-inflammatory drugs currently used to treat rheumatoid arthritis.

Single gene determines if rare lymphatic system cancer is aggressive

For a rare form of cancer called thymoma, researchers have discovered a single gene defining the difference between a fast-growing tumor requiring aggressive treatment and a slow-growing tumor that does not require extensive therapy.

More than 40 melanoma-specific genes determine disease aggressiveness

Researchers have discovered more than 40 genes that predict the level of aggressiveness of melanoma and that distinguish it from other cancers with a poor prognosis.