The Colorectal Cancer
Group at MOMA
Colorectal cancer (CRC) represents a major public health
In Denmark approximately 4.000 new cases are diagnosed every year.
At the primary diagnosis 80% of the patients will undergo “curative”
resection, while 20% will only be offered palliative resection due to
disseminated disease. However, among the “curatively” resected
patients approx. 40-45% will develop recurrent disease within the next
five years, resulting in an overall long-term survival of approximately
Three of the largest challenges in the management of CRC
today are the ability to
1) detect CRC at earlier stages
2) distinguish between highly aggressive and latent tumors
3) to predict response to oncological therapy.
Early detection will improve survival
At the time of first diagnosis half of the patients will have stage I
or II disease, and the other half of the patients will have disseminated
disease – stage III or IV.
It is expected that overall survival could be substantially improved if
more patients were detected at an earlier stage. However, no current method
(biomarker) efficiently enables early detection of CRC in asymptomatic
Different risk of recurrence
Of the “curatively” resected stage II and III cancer patients
approximately ~20% and ~50% will experience later recurrence of disease.
As a consequence stage II and III patients are offered adjuvant chemotherapy.
Unfortunately, the routine prognostic indicators available today cannot
distinguish clearly between the patients with high and low recurrence
risk. The result is that a significant fraction of the patients are over-treated
with chemotherapy regimens that they do not need.
Response to treatment
The major treatment modality for stage IV patients (with distant metastases)
Here another problem exists, namely that a large percentage of patients
receiving therapy do not obtain an objective remission while they most
often experience substantial side effects.
Today oncologists have a wide range of combinatorial regimens available
e.g. 5FU/oxaliplatin (FOLFOX, XELOX). Unfortunately, it is currently not
possible to predict which combination will be effective for a given patient.
Therefore, one way to improve current oncological management of stage
IV patients is to develop predictive biomarkers that can help guiding
the oncologist in choosing the most optimal regiment as 1. line treatment.
Such an approach should not only result in increased patient survival
but also in increased patient quality of life. In addition, the society
will save significant economical resources that today are being used on
The primary aim of our research is to pave the way for better personalized
treatment of patients with CRC.
The approach is translational, integrating clinical and basic studies
to identify and develop new molecular markers for CRC to enable early
detection and to increase the accuracy of diagnosis, prognosis, and prediction
of treatment response.
The Colorectal Cancer Tissue Bank
The Colorectal Cancer Tissue
Bank is located at the CMCC and is maintained in a collaborative effort
by the Colorectal Cancer Group and the
The bank was established in 1999 in order to facilitate the translation
of laboratory research into clinical practise.
At the Surgical Departments dedicated nurses and technicians are responsible
for the collection of blood, normal colon mucosa, adenoma, adenocarcinoma,
and metastatic liver tissues. All patients included have received oral
and written information about the tissue bank and have given written consent.
Currently the bank holds biologically and clinically well-defined tissue,
carefully isolated RNA, DNA and protein extracts, and associated clinical
and pathological data from more than 2000 patients. Roughly 350 new patients
are added to the bank each year.
For specific subsets of patient’s tissue microarrays (TMAs) containing
formalin fixed and paraffin embedded tumor tissues have been created.
Available is for example a TMA with tumor tissue from 300 consecutive
collected stage II cancer patients with a minimum of 3 years of follow-up
(incl. disease free and overall survival).
The tissue bank has been approved by the Central Denmark Region Committee
on Biomedical Research Ethics and the Danish Data Protection Agency.
Associate Professor, MSc, PhD
phone: +45 7845 5319