In a groundbreaking study, scientists have pinpointed a critical “Big Bang” moment in the progression of bowel cancer, marking a pivotal stage in the disease’s development. This moment occurs when cancer cells successfully evade detection by the immune system, similar to the universe’s rapid expansion at the dawn of time. During this phase, known as immune escape, bowel cancer cells alter genes, preventing the immune system from recognizing the cancer.

Researchers from The Institute of Cancer Research (ICR) in London have highlighted that after this immune escape, the way cancer interacts with the immune system remains relatively unchanged. Professor Trevor Graham, director of the ICR’s Centre for Evolution, noted, “Some bowel cancers are ‘born to be bad.’ Their interaction with the immune system is established early in their development.”

Graham emphasized the potential of immunotherapy and vaccines in combating bowel cancer, stating, “Our findings suggest that the relationship between bowel cancer and the immune system is established early and remains stable. Targeting this relationship early could significantly improve treatment outcomes.”

Bowel cancer ranks as the fourth most prevalent cancer in the UK, with approximately 44,000 new cases annually. However, only about 15% of these cancers respond effectively to immunotherapy. The study analyzed bowel cancer cells from 29 patients, providing valuable insights into potential treatment strategies.

Eszter Lakatos, the study’s lead author and a mathematical biologist at both Chalmers University of Technology and the University of Gothenburg in Sweden, expressed optimism about the research. “We hope these findings will pave the way for more targeted, effective early treatments, complementing surgical options,” she said.

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.”