Oral drug reduces formation of precancerous polyps in the colon, UB researchers find

An oral biologic medication has successfully treated chronic, precancerous inflammation in the intestine, according to results of an animal study authored by an MD/PhD student in the University at Buffalo School of Medicine and Biomedical Sciences.

The study is featured on the cover of the current issue of Cancer Research; it was published online ahead of print in September. The journal’s editors characterized the study’s findings as “striking.”

Inflammatory cells in the colon, or polyps, are very common after the age of 50. The average 60-year-old has an estimated 25 percent chance of having polyps. Most polyps are benign, but some will develop into colon cancer. For that reason, the standard treatment for polyps is to remove them.

“Our most important finding is that disease-promoting inflammatory cells in the mouse intestine can be targeted by oral formulations of purified cellular proteins, rendering the inflammatory cells less able to cause disease,” says first author Allen Chung, an MD/PhD student in the UB medical school’s Medical Scientist Training Program.

According to the paper, this is one of the first times an oral biologic has been used successfully to change the natural history of a genetic disease; in this case, a mutation that puts individuals at very high risk for colon cancer.

Oral biologics are drugs based on biological molecules derived from natural substances from humans, animals or microorganisms. They have an obvious advantage over other biologics, which must be injected or otherwise administered.

Several conditions of the colon can lead to colorectal cancer. What are they and how are they treated?

Adenomatous polyps. These types of polyps are more likely than others to become cancerous. During a screening with sigmoidoscopy or colonoscopy, polyps can be seen and removed. The type of polyp can be determined in a lab.

Here is how adenomatous colon polyps are treated:

A single polyp found during a flexible sigmoidoscopy exam will usually lead to follow-up colonoscopy to look for other polyps.

Then, once the colon is "clean" of polyps, experts recommend repeat colonoscopy every 1 to 3 years.

If follow-up exams continue to be normal, further screening recommendations will be determined by your doctor.

Familial adenomatous polyposis (FAP). There is continued controversy over how to manage patients with FAP. Almost all untreated patients have colorectal cancer by age 40, therefore some surgical treatment is needed. Here's how FAP is usually managed:

Total colectomy with anastomosis of the ileum with the rectum, unless the rectum has polyps.