Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer

Mark Lawler; Deborah Alsina; Richard A. Adams; Annie S. Anderson; Gina Brown; Nicola S. Fearnhead; Stephen W. Fenwick; Stephen P. Halloran; Daniel Hochhauser; Mark A. Hull; Viktor H. Koelzer; Angus G. K. McNair; Kevin J. Monahan; Inke Näthke; Christina Norton; Marco R. Novelli; Robert J. C. Steele; Anne L. Thomas; Lisa M. Wilde; Richard H. Wilson; Ian Tomlinson; Bowel Cancer UK Critical Research Gaps in Colorectal Cancer Initiative; Simon Bach

doi:10.1136/gutjnl-2017-315333

Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer

Mark Lawler, Deborah Alsina, Richard A. Adams, Annie S. Anderson, Gina Brown, Nicola S. Fearnhead, Stephen W. Fenwick, Stephen P. Halloran, Daniel Hochhauser, Mark A. Hull, Viktor H. Koelzer, Angus G. K. McNair, Kevin J. Monahan, Inke Näthke, Christina Norton, Marco R. Novelli, Robert J. C. Steele, Anne L. Thomas, Lisa M. Wilde, Richard H. WilsonIan Tomlinson, Bowel Cancer UK Critical Research Gaps in Colorectal Cancer Initiative, Simon Bach

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Abstract

Objective Colorectal cancer (CRC) leads to significant morbidity/mortality worldwide. Defining critical research gaps (RG), their prioritisation and resolution, could improve patient outcomes.

Design RG analysis was conducted by a multidisciplinary panel of patients, clinicians and researchers (n=71). Eight working groups (WG) were constituted: discovery science; risk; prevention; early diagnosis and screening; pathology; curative treatment; stage IV disease; and living with and beyond CRC. A series of discussions led to development of draft papers by each WG, which were evaluated by a 20-strong patient panel. A final list of RGs and research recommendations (RR) was endorsed by all participants.

Results Fifteen critical RGs are summarised below: RG1: Lack of realistic models that recapitulate tumour/tumour micro/macroenvironment; RG2: Insufficient evidence on precise contributions of genetic/environmental/lifestyle factors to CRC risk; RG3: Pressing need for prevention trials; RG4: Lack of integration of different prevention approaches; RG5: Lack of optimal strategies for CRC screening; RG6: Lack of effective triage systems for invasive investigations; RG7: Imprecise pathological assessment of CRC; RG8: Lack of qualified personnel in genomics, data sciences and digital pathology; RG9: Inadequate assessment/communication of risk, benefit and uncertainty of treatment choices; RG10: Need for novel technologies/interventions to improve curative outcomes; RG11: Lack of approaches that recognise molecular interplay between metastasising tumours and their microenvironment; RG12: Lack of reliable biomarkers to guide stage IV treatment; RG13: Need to increase understanding of health related quality of life (HRQOL) and promote residual symptom resolution; RG14: Lack of coordination of CRC research/funding; RG15: Lack of effective communication between relevant stakeholders.

Conclusion Prioritising research activity and funding could have a significant impact on reducing CRC disease burden over the next 5 years.

Original language	English
Pages (from-to)	179-193
Journal	Gut
Volume	67
Issue number	1
Early online date	12 Dec 2017
DOIs	https://doi.org/10.1136/gutjnl-2017-315333
Publication status	Published - Jan 2018

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Lawler, M., Alsina, D., Adams, R. A., Anderson, A. S., Brown, G., Fearnhead, N. S., Fenwick, S. W., Halloran, S. P., Hochhauser, D., Hull, M. A., Koelzer, V. H., McNair, A. G. K., Monahan, K. J., Näthke, I., Norton, C., Novelli, M. R., Steele, R. J. C., Thomas, A. L., Wilde, L. M., ... Bach, S. (2018). Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer. Gut, 67(1), 179-193. Advance online publication. https://doi.org/10.1136/gutjnl-2017-315333

@article{cccd27848f624fdf9f0acd9cc32f8b4e,

title = "Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer",

abstract = "Objective Colorectal cancer (CRC) leads to significant morbidity/mortality worldwide. Defining critical research gaps (RG), their prioritisation and resolution, could improve patient outcomes.Design RG analysis was conducted by a multidisciplinary panel of patients, clinicians and researchers (n=71). Eight working groups (WG) were constituted: discovery science; risk; prevention; early diagnosis and screening; pathology; curative treatment; stage IV disease; and living with and beyond CRC. A series of discussions led to development of draft papers by each WG, which were evaluated by a 20-strong patient panel. A final list of RGs and research recommendations (RR) was endorsed by all participants.Results Fifteen critical RGs are summarised below: RG1: Lack of realistic models that recapitulate tumour/tumour micro/macroenvironment; RG2: Insufficient evidence on precise contributions of genetic/environmental/lifestyle factors to CRC risk; RG3: Pressing need for prevention trials; RG4: Lack of integration of different prevention approaches; RG5: Lack of optimal strategies for CRC screening; RG6: Lack of effective triage systems for invasive investigations; RG7: Imprecise pathological assessment of CRC; RG8: Lack of qualified personnel in genomics, data sciences and digital pathology; RG9: Inadequate assessment/communication of risk, benefit and uncertainty of treatment choices; RG10: Need for novel technologies/interventions to improve curative outcomes; RG11: Lack of approaches that recognise molecular interplay between metastasising tumours and their microenvironment; RG12: Lack of reliable biomarkers to guide stage IV treatment; RG13: Need to increase understanding of health related quality of life (HRQOL) and promote residual symptom resolution; RG14: Lack of coordination of CRC research/funding; RG15: Lack of effective communication between relevant stakeholders.Conclusion Prioritising research activity and funding could have a significant impact on reducing CRC disease burden over the next 5 years.",

author = "Mark Lawler and Deborah Alsina and Adams, {Richard A.} and Anderson, {Annie S.} and Gina Brown and Fearnhead, {Nicola S.} and Fenwick, {Stephen W.} and Halloran, {Stephen P.} and Daniel Hochhauser and Hull, {Mark A.} and Koelzer, {Viktor H.} and McNair, {Angus G. K.} and Monahan, {Kevin J.} and Inke N{\"a}thke and Christina Norton and Novelli, {Marco R.} and Steele, {Robert J. C.} and Thomas, {Anne L.} and Wilde, {Lisa M.} and Wilson, {Richard H.} and Ian Tomlinson and {Bowel Cancer UK Critical Research Gaps in Colorectal Cancer Initiative} and Simon Bach",

year = "2018",

month = jan,

doi = "10.1136/gutjnl-2017-315333",

language = "English",

volume = "67",

pages = "179--193",

journal = "Gut",

issn = "0017-5749",

publisher = "BMJ Publishing Group",

number = "1",

}

Lawler, M, Alsina, D, Adams, RA, Anderson, AS, Brown, G, Fearnhead, NS, Fenwick, SW, Halloran, SP, Hochhauser, D, Hull, MA, Koelzer, VH, McNair, AGK, Monahan, KJ, Näthke, I, Norton, C, Novelli, MR, Steele, RJC, Thomas, AL, Wilde, LM, Wilson, RH, Tomlinson, I, Bowel Cancer UK Critical Research Gaps in Colorectal Cancer Initiative & Bach, S 2018, 'Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer', Gut, vol. 67, no. 1, pp. 179-193. https://doi.org/10.1136/gutjnl-2017-315333

TY - JOUR

T1 - Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer

AU - Lawler, Mark

AU - Alsina, Deborah

AU - Adams, Richard A.

AU - Anderson, Annie S.

AU - Brown, Gina

AU - Fearnhead, Nicola S.

AU - Fenwick, Stephen W.

AU - Halloran, Stephen P.

AU - Hochhauser, Daniel

AU - Hull, Mark A.

AU - Koelzer, Viktor H.

AU - McNair, Angus G. K.

AU - Monahan, Kevin J.

AU - Näthke, Inke

AU - Norton, Christina

AU - Novelli, Marco R.

AU - Steele, Robert J. C.

AU - Thomas, Anne L.

AU - Wilde, Lisa M.

AU - Wilson, Richard H.

AU - Tomlinson, Ian

AU - Bowel Cancer UK Critical Research Gaps in Colorectal Cancer Initiative

AU - Bach, Simon

PY - 2018/1

Y1 - 2018/1

N2 - Objective Colorectal cancer (CRC) leads to significant morbidity/mortality worldwide. Defining critical research gaps (RG), their prioritisation and resolution, could improve patient outcomes.Design RG analysis was conducted by a multidisciplinary panel of patients, clinicians and researchers (n=71). Eight working groups (WG) were constituted: discovery science; risk; prevention; early diagnosis and screening; pathology; curative treatment; stage IV disease; and living with and beyond CRC. A series of discussions led to development of draft papers by each WG, which were evaluated by a 20-strong patient panel. A final list of RGs and research recommendations (RR) was endorsed by all participants.Results Fifteen critical RGs are summarised below: RG1: Lack of realistic models that recapitulate tumour/tumour micro/macroenvironment; RG2: Insufficient evidence on precise contributions of genetic/environmental/lifestyle factors to CRC risk; RG3: Pressing need for prevention trials; RG4: Lack of integration of different prevention approaches; RG5: Lack of optimal strategies for CRC screening; RG6: Lack of effective triage systems for invasive investigations; RG7: Imprecise pathological assessment of CRC; RG8: Lack of qualified personnel in genomics, data sciences and digital pathology; RG9: Inadequate assessment/communication of risk, benefit and uncertainty of treatment choices; RG10: Need for novel technologies/interventions to improve curative outcomes; RG11: Lack of approaches that recognise molecular interplay between metastasising tumours and their microenvironment; RG12: Lack of reliable biomarkers to guide stage IV treatment; RG13: Need to increase understanding of health related quality of life (HRQOL) and promote residual symptom resolution; RG14: Lack of coordination of CRC research/funding; RG15: Lack of effective communication between relevant stakeholders.Conclusion Prioritising research activity and funding could have a significant impact on reducing CRC disease burden over the next 5 years.

AB - Objective Colorectal cancer (CRC) leads to significant morbidity/mortality worldwide. Defining critical research gaps (RG), their prioritisation and resolution, could improve patient outcomes.Design RG analysis was conducted by a multidisciplinary panel of patients, clinicians and researchers (n=71). Eight working groups (WG) were constituted: discovery science; risk; prevention; early diagnosis and screening; pathology; curative treatment; stage IV disease; and living with and beyond CRC. A series of discussions led to development of draft papers by each WG, which were evaluated by a 20-strong patient panel. A final list of RGs and research recommendations (RR) was endorsed by all participants.Results Fifteen critical RGs are summarised below: RG1: Lack of realistic models that recapitulate tumour/tumour micro/macroenvironment; RG2: Insufficient evidence on precise contributions of genetic/environmental/lifestyle factors to CRC risk; RG3: Pressing need for prevention trials; RG4: Lack of integration of different prevention approaches; RG5: Lack of optimal strategies for CRC screening; RG6: Lack of effective triage systems for invasive investigations; RG7: Imprecise pathological assessment of CRC; RG8: Lack of qualified personnel in genomics, data sciences and digital pathology; RG9: Inadequate assessment/communication of risk, benefit and uncertainty of treatment choices; RG10: Need for novel technologies/interventions to improve curative outcomes; RG11: Lack of approaches that recognise molecular interplay between metastasising tumours and their microenvironment; RG12: Lack of reliable biomarkers to guide stage IV treatment; RG13: Need to increase understanding of health related quality of life (HRQOL) and promote residual symptom resolution; RG14: Lack of coordination of CRC research/funding; RG15: Lack of effective communication between relevant stakeholders.Conclusion Prioritising research activity and funding could have a significant impact on reducing CRC disease burden over the next 5 years.

U2 - 10.1136/gutjnl-2017-315333

DO - 10.1136/gutjnl-2017-315333

M3 - Article

SN - 0017-5749

VL - 67

SP - 179

EP - 193

JO - Gut

JF - Gut

IS - 1

ER -

Critical research gaps and recommendations to inform research prioritisation for more effective prevention and improved outcomes in colorectal cancer

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