Leading expert in colorectal cancer, Dr. Heinz-Josef Lenz, MD, explains how precision medicine will transform colon cancer treatment and lead to a cure. He details the future of full molecular profiling for every patient, real-time monitoring of tumor genetics to predict and prevent resistance, and the reclassification of metastatic colon cancer into dozens of molecularly distinct diseases. Dr. Lenz envisions targeting cancer stem cells and developing specific prevention strategies, aiming to cure all patients within a decade.
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Precision Medicine Advances in Colorectal Cancer Treatment and Future Cure
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- Molecular Profiling Future
- Real-Time Monitoring & Resistance
- Redefining Metastatic Disease
- Targeting Cancer Stem Cells
- Personalized Prevention Strategies
- Full Transcript
Molecular Profiling Future
Dr. Heinz-Josef Lenz, MD, predicts that comprehensive molecular profiling will soon become standard for all colon cancer patients. This full genetic analysis of a tumor moves beyond current limited testing for markers like KRAS, NRAS, BRAF, and MSI. Dr. Heinz-Josef Lenz, MD, explains that this extensive molecular profiling is the cornerstone of precision medicine, enabling oncologists to select the most effective, personalized treatment plan for each individual.
Real-Time Monitoring & Resistance
A critical future advance in colorectal cancer treatment involves real-time monitoring of a tumor's molecular profile during therapy. Dr. Heinz-Josef Lenz, MD, states that this approach allows physicians to identify the specific mechanisms of chemotherapy resistance as they develop. This capability means doctors can predict cancer progression and alter treatment before tumor growth is even visible on a CT scan, fundamentally changing disease management from reactive to proactive.
Redefining Metastatic Disease
Precision medicine will redefine metastatic colon cancer not as a single disease, but as 40 to 100 different molecularly defined diseases. Dr. Heinz-Josef Lenz, MD, emphasizes that each unique genetic profile will dictate a highly specific and effective treatment strategy. This detailed molecular classification promises treatments with higher efficacy and lower toxicity, moving away from a one-size-fits-all approach to advanced colorectal cancer care.
Targeting Cancer Stem Cells
A major future goal is developing medications that specifically target colon cancer stem cells. Dr. Heinz-Josef Lenz, MD, identifies these cells as the ultimate reason for treatment failure in metastatic disease, as they are resistant to both classical chemotherapy and current targeted therapies. Successfully differentiating and eliminating these resilient stem cells is considered essential to achieving a lasting cure for colorectal cancer patients.
Personalized Prevention Strategies
The future of colorectal cancer care extends beyond treatment to include molecularly-guided prevention. Dr. Lenz envisions strategies based on a deep understanding of tumor biology, which could include specific dietary recommendations or preventive medications for high-risk individuals. This shift towards personalized prevention, informed by family history and genetic risk, aims to stop cancer before it even develops.
Full Transcript
Dr. Heinz-Josef Lenz, MD: In the next few years, we will do full molecular profiling of all colon cancer patients. We will monitor colon cancer molecular profile changes in real time. We can identify the mechanism of resistance to chemotherapy. We can predict progression of colon cancer.
Metastatic colon cancer will not be one disease anymore. It may be 50 diseases, 40 diseases, or 100 diseases. Cancer is defined by the molecular profiling of the colon cancer tumor. In 10 years, I hope we will have cured all colon cancer patients.
Dr. Anton Titov, MD: This has been a very interesting conversation. It's important to talk about what the future will bring in the treatment of colon cancer and rectal cancer. You are very positive about very exciting treatments of colon cancer. Success is facilitated by personalized medicine and precision medicine.
There is specific molecular testing and diagnosis of patients with colon cancer. You are a leader in colorectal cancer research and treatment. What do you see as the most important new diagnostic and treatment options in the next 10 years for patients with colorectal cancer?
Maybe you could give some specific examples of colon cancer treatment advances. Please add to what you've already talked about.
Dr. Heinz-Josef Lenz, MD: I don't know what will happen in 10 years, but I will tell you what will happen in the next couple of years. I think it happens already in very select clinics. We will do full molecular profiling of colon cancer patients. Extensive molecular profiles of colon cancer tumors will be done.
But they will sometimes make it very difficult for us to understand what all the genetic profiling results really mean. Molecular tumor profiling allows us now to select the best treatment options for colorectal cancer patients.
We will monitor colon cancer molecular profile changes in real time. We can identify the mechanism of resistance to chemotherapy. We can predict risks of progression of colon cancer. We will know before the colon cancer tumor starts growing again.
We will see into the future what will happen with the tumor. This will allow us to interfere with the treatment before colon cancer progression is visible on a CT scan. That's the first future advance in colon cancer treatment.
The second advance in colon cancer treatment is this: with the molecular classification of colon cancer, we will develop treatment options for more patients. Precision medicine treatment is defined by the unique patient and tumor profile.
Today, we have only the KRAS molecular tumor marker. Tomorrow, we will have many molecular tumor profile factors. They will point very clearly to specific treatments with high efficacy and low toxicity.
Colon cancer and metastatic colon cancer will not be one disease anymore. It may be 50 diseases, 40 diseases, or 100 diseases. Each variant of cancer will be defined by the molecular profiling of the colon cancer tumor.
With this approach, the goal has to be to cure more and more patients. I think in the future we will have very specific new medications that target colon cancer stem cells. Cancer stem cells are the ultimate reason for the failure of all our treatments of metastatic colon cancer.
Colon cancer stem cells cannot be treated or killed by classical chemotherapy treatments. Cancer stem cells cannot be eliminated even by the new targeted medications that we have now.
We really need to differentiate colon cancer stem cells from simple tumor cells. Then we can kill differentiated cancer stem cells with chemotherapy. In 10 years, I hope we will have cured all colon cancer patients.
We will develop very molecular-specific prevention strategies for colorectal cancer. That will prevent colon cancer in the future. Colon cancer prevention strategies should be based on our understanding of the molecular biology of colon cancer tumor cells.
Colon cancer prevention methods will include eating broccoli and consuming more fiber. It will be very specific family intervention in very specific high-risk patients for colon cancer development.
To prevent colon cancer effectively, we will know that certain high-risk people will need to use this medication or that medication in the future.
Dr. Anton Titov, MD: This is a very exciting conversation. Professor Lenz, thank you very much for sharing your enthusiasm for your research achievements. Thank you for sharing insights from your clinical work in colorectal cancer. Thank you very much for this conversation!
We are looking forward to returning to the conversation in the future.
Dr. Heinz-Josef Lenz, MD: Absolutely. Thank you so much! The future of precision medicine in colorectal cancer is now. Metastatic stage 4 colon cancer patients will be cured with molecular medicine advances.