Does 5-ASA prevent colorectal cancer progression by targeting cancer stem cells

Summary

Bowel or Colon cancer is the second-most common cause of cancer death in the UK despite advances in screening and treatment. It has recently been proposed that the growth of colon tumours is driven by a subset of cells within the tumour itself, referred to as the cancer stem cells. There is growing evidence that cancer stem cells are responsible not only for tumour development and progression, but also for resistance to traditional chemotherapy and recurrence after cessation of treatment. This makes them an attractive treatment target.

5-aminosalicylic acid (S-ASA) is an anti-inflammatory drug widely used in the treatment of inflammatory bowel disease (IBD). It is a cheap, well-tolerated medication with few side-effects. It has also been noted to reduce the incidence of colon cancer in certain groups of IBD patients, although the mechanism is not fully understood. Related anti-inflammatory drugs have been used in the prevention of colonic polyps (cancer precursors) but they have significant side effects that limit their widespread use.

Recent work from this laboratory has demonstrated the novel finding that 5-ASA is effective in laboratory models of colon cancer in suppressing stem cell markers. This would suggest that this medication may have a role in augmenting current treatments of colon cancer by targeting cancer stem cells.

In this pilot study we plan to study how 5-ASA acts upon cancer stem cells which will enable us to design future clinical trials using 5-ASA to augment current treatments for colon cancer.