ABSTRACT
Conventional therapy for colorectal cancer has made little impact on 5-year survival figures over the last decade. For most patients with colorectal cancer, the prognosis remains poor, and novel therapeutic concepts are urgently needed. Significant advances in our understanding of the molecular and cellular events that accompany the development of colorectal cancer (see Chapter 1) have identified specific targets for novel therapeutic approaches. Key discoveries have been the adenomatous polyposis coli (APC) and p53 genes and the elucidation of signalling pathways controlling the initiation and progression of tumours, along with a better understanding of the immunological interplay in the development of colorectal cancer. Another critical factor that has facilitated this process has been the concurrent expansion in technological innovations. Although we are just beginning to unravel the complex processes during tumorigenesis, significant progress has been made in the development of novel therapies, such as gene therapy and immunotherapy approaches. The initial results are encouraging, but the work is still at an early stage of development and preclinical studies are only just being translated into clinical trials, which will require evaluation in well-designed randomized controlled trials. This chapter will review the current state of these emerging therapeutic modalities and evaluate their clinical effectiveness.
