Major bowel cancer breakthrough discovers 'Big Bang' moment in disease

Scientists have identified a key "Big Bang" moment in the development of bowel cancer which sets the course for how it will grow. Researchers found that the point at which cancer cells successfully hide from the immune system was key in the disease's development - like the moment of rapid expansion thought to have started the universe. During this so-called immune escape, bowel cancer cells disrupt genes which allow the cancer to be detected.

Experts at The Institute of Cancer Research (ICR) in London said that after this point there were very limited changes in how cancer presents itself to the immune system. Professor Trevor Graham, director of the ICR's centre for evolution, said: "Some bowel cancers are 'born to be bad.' How they interact with the immune system is set early on.

"Immunotherapy and bowel cancer vaccines hold enormous promise for treating the disease. Our research suggests that a bowel cancer's relationship with the immune system doesn't change very much as it grows.

"If we can target that relationship early on, treatment should have a stronger chance of success."

Bowel cancer is the fourth most common cancer in the UK with around 44,000 new cases every year. Only around 15% of bowel cancers respond well to immunotherapy. The research looked at cells in bowel cancers from 29 people.

Study lead author Eszter Lakatos, a mathematical biologist at Chalmers University of Technology and the University of Gothenburg, Sweden, said: "Our hope is that these insights will eventually lead to more targeted, effective and early treatments, in addition to surgery."

Dr Catherine Elliott, director of research at Cancer Research UK, which part-funded the research, said: "To beat bowel cancer for everyone, we need to understand what happens at the very earliest stages of the disease.

"No matter how different bowel cancer tumours can look, one defining moment at the start makes a big difference to how the cancer grows.

"Bowel cancer has an insidious ability to resist treatment. Immunotherapy is starting to work well for patients, but it doesn't work for everyone.

"This research helps us understand why, as well as giving us new insights to make immunotherapy work better for bowel cancer."

Tom Collins, research lead for discovery research at the Wellcome Trust, said: "Through tracing the earliest stages of bowel cancer, the research team has shed valuable new light on a mechanism that could lead to more targeted, effective and early treatments.

"This is a powerful example of discovery science. Research at this molecular level has provided a deeper understanding of how bowel cancer develops, which could lead to the improved health outcomes for patients in the long-term."