Colorectal Cancer Diagnosis and Therapeutic Updates

137 Pages·2022·17.815 MB·English

by  Sankha Bhattacharya, Amit Page, Saurabh Maru, Shilpa Dawre

Colorectal Cancer Diagnosis and
Therapeutic Updates
Edited by
Sankha Bhattacharya
Department of Pharmaceutics
School of Pharmacy & Technology Management
SVKM'S NMIMS Deemed-to-be University
India
Amit Page
Department of Pharma Science
School of Pharmacy & Technology Management
SVKM'S NMIMS Deemed-to-be University
India
Saurabh Maru
Department of Pharmacology
School of Pharmacy & Technology Management
SVKM'S NMIMS Deemed-to-be University
India
&
Shilpa Dawre
Department of Pharmaceutics
School of Pharmacy & Technology Management
SVKM'S NMIMS Deemed-to-be University
India
Colorectal Cancer Diagnosis and Therapeutic Updates
Editors: Sankha Bhattacharya, Amit Page, Saurabh Maru and Shilpa Dawre
ISBN (Online): 978-981-5040-94-4
ISBN (Print): 978-981-5040-95-1
ISBN (Paperback): 978-981-5040-96-8
© 2022, Bentham Books imprint.
Published by Bentham Science Publishers Pte. Ltd. Singapore. All Rights Reserved.
First published in 2022
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CONTENTS
FOREWORD ........................................................................................................................................... i
PREFACE ................................................................................................................................................ ii
ACKNOWLEDGEMENT ...................................................................................................................... iv
LIST OF CONTRIBUTORS .................................................................................................................. v
CHAPTER 1 COLORECTAL CANCER DIAGNOSIS .................................................................... 1
Sankha Bhattacharya, Amit Page, Kapil Gore and Amaiyya Agrawal
INTRODUCTION .......................................................................................................................... 1
Invasive Examination .............................................................................................................. 2
NON-INVASIVE DIAGNOSIS METHODS ................................................................................ 3
Fecal Occult Blood Test .......................................................................................................... 3
Non-enzymatic Tumor Markers .............................................................................................. 4
Lysosomal Exoglycosidases as Potential CRC Markers ........................................................ 5
CONCLUSION ............................................................................................................................... 6
CONSENT FOR PUBLICATION ................................................................................................ 6
CONFLICT OF INTEREST ......................................................................................................... 6
ACKNOWLEDGEMENTS ........................................................................................................... 6
REFERENCES ............................................................................................................................... 6
CHAPTER 2 SCREENING FOR COLORECTAL CARCINOMA ................................................ 8
Sankha Bhattacharya, Saurabh Maru and Aseem Setia
INTRODUCTION .......................................................................................................................... 8
DETECTION OF EARLY COLORECTAL CARCINOMA ..................................................... 9
EARLY DIAGNOSIS OF COLORECTAL CARCINOMA ...................................................... 9
WHAT IS SCREENING? .............................................................................................................. 9
WHO SHOULD BE SCREENED? ............................................................................................... 9
SCREENING PEOPLE AT AN AVERAGE RISK FOR COLORECTAL CARCINOMA ... 10
Fecal Occult Blood Test .......................................................................................................... 10
Flexible Sigmoidoscopy .......................................................................................................... 11
Combination of FOBT and Flexible Sigmoidoscopy ............................................................. 11
Colonoscopy ........................................................................................................................... 11
SCREENING PEOPLE AT INCREASED RISK FOR COLORECTAL CARCINOMA ...... 12
Genetic Syndromes ................................................................................................................. 12
NEW SCREENING TESTS ........................................................................................................... 13
CT Colonography .................................................................................................................... 13
Faecal Occult Blood Test ........................................................................................................ 13
CONCLUSION ............................................................................................................................... 13
CONSENT FOR PUBLICATION ................................................................................................ 13
CONFLICT OF INTEREST ......................................................................................................... 13
ACKNOWLEDGEMENTS ........................................................................................................... 13
REFERENCES ............................................................................................................................... 14
CHAPTER 3 HISTOPATHOLOGY ................................................................................................... 16
Sankha Bhattacharya, Shilpa Dawre and Dyanesh Saindane
INTRODUCTION .......................................................................................................................... 16
NORMAL HISTOLOGY OF COLORECTAL AREA .............................................................. 16
GENERAL PRESENTATION IN COLORECTAL CANCER ................................................. 17
NEED FOR HISTOPATHOLOGICAL INSPECTION IN COLORECTAL CARCINOMA 18
FACTORS INVOLVED IN THE HISTOPATHOLOGICAL ANALYSIS OF
COLORECTAL CARCINOMA ................................................................................................... 18
HISTOPATHOLOGIC DIAGNOSIS OF COLORECTAL CANCER ..................................... 19
HISTOLOGIC VARIANTS .......................................................................................................... 20
GRADING OF COLORECTAL CARCINOMA USING HISTOPATHOLOGICAL
ANALYSIS ...................................................................................................................................... 20
Process of Grading the Cancers .............................................................................................. 21
Issues with PDC System and their Rectification ........................................................... 22
CONCLUSION ............................................................................................................................... 22
CONSENT FOR PUBLICATION ................................................................................................ 22
CONFLICT OF INTEREST ......................................................................................................... 22
ACKNOWLEDGEMENTS ........................................................................................................... 22
REFERENCES ............................................................................................................................... 22
CHAPTER 4 CHEMOTHERAPY AND COLORECTAL CANCER ............................................. 24
Kapil Gore, Dnyanesh Saindane and Sankha Bhattacharya
INTRODUCTION .......................................................................................................................... 24
CHEMOTHERAPY AND COLORECTAL CANCER .............................................................. 24
Administration of Chemotherapeutic Agents ........................................................................ 24
CHEMOTHERAPY IN DIFFERENT STAGES OF COLORECTAL CANCER ................... 25
COMPONENTS OF CHEMOTHERAPY ................................................................................... 26
5-Fluorouracil (5-FU) ............................................................................................................. 26
Irinotecan ................................................................................................................................ 27
Oxaliplatin ............................................................................................................................... 27
NOVEL THERAPIES FOR COLORECTAL CARCINOMA .................................................. 27
Agarose Microbeads ............................................................................................................... 27
Anti-inflammatory Agents ...................................................................................................... 28
Probiotics ................................................................................................................................ 28
Functional Foods ..................................................................................................................... 28
TARGETED THERAPIES ............................................................................................................ 29
Targeting EGFR ...................................................................................................................... 29
Cetuximab and Panitumumab ................................................................................................. 29
BRAF Inhibitors ...................................................................................................................... 30
HER-2 Inhibitors ..................................................................................................................... 30
Targeting VEGF ...................................................................................................................... 30
Bevacizumab ........................................................................................................................... 30
Novel anti-VEGFR Agents ..................................................................................................... 31
HGF/C-MET Pathway ............................................................................................................ 31
HGF Inhibitors ........................................................................................................................ 32
MET Antagonists .................................................................................................................... 32
TKIs ........................................................................................................................................ 32
IMMUNE CHECKPOINT BLOCKADE ..................................................................................... 32
ADJUVANT AND NEOADJUVANT THERAPY USING TARGETED MEDICINE ........... 33
CONCLUSION ............................................................................................................................... 34
CONSENT FOR PUBLICATION ................................................................................................ 34
CONFLICT OF INTEREST ......................................................................................................... 34
ACKNOWLEDGEMENTS ........................................................................................................... 34
REFERENCES ............................................................................................................................... 34
CHAPTER 5 ROBOTICS FOR RECTAL CANCER ....................................................................... 37
Dnyanesh Saindane, Ajay Madrewar and Sankha Bhattacharya
INTRODUCTION .......................................................................................................................... 37
TOTAL MESORECTAL EXCISION .......................................................................................... 37
Techniques Abdominoperineal Resection .............................................................................. 38
Coloanal Anastomosis ............................................................................................................ 38
LOCAL EXCISION ....................................................................................................................... 38
Transanal Excision .................................................................................................................. 38
Transcoccygeal Excision ........................................................................................................ 39
Transsphincteric Excision ....................................................................................................... 39
Transanal Endoscopic Microsurgery ...................................................................................... 39
DISADVANTAGES OF SURGICAL TREATMENT FOR RECTAL CANCER ................... 40
Short Term Effects of Surgery ................................................................................................ 40
Long Term Effects .................................................................................................................. 40
LAPAROSCOPIC SURGERY ...................................................................................................... 40
ADVANTAGES OVER CONVENTIONAL SURGICAL METHODS .................................... 40
Short Term Advantages Are: .................................................................................................. 40
Long Term Advantages ........................................................................................................... 41
Limitations of Laparoscopic Surgery ...................................................................................... 41
ROBOTIC SURGERY FOR COLORECTAL CANCER .......................................................... 42
Components of the da Vinci surgical System ......................................................................... 42
Operation of the System .......................................................................................................... 42
OUTCOMES OF DA VINCI SURGICAL SYSTEM ................................................................. 43
Short Term Outcomes ............................................................................................................. 43
Long Term Outcomes ............................................................................................................. 43
CONCLUSION ............................................................................................................................... 44
CONSENT FOR PUBLICATION ................................................................................................ 44
CONFLICT OF INTEREST ......................................................................................................... 44
ACKNOWLEDGEMENTS ........................................................................................................... 44
REFERENCES ............................................................................................................................... 44
CHAPTER 6 LNCRNA NLIPMT INHIBITORS IN COLORECTAL CANCER
MANAGEMENT ..................................................................................................................................... 46
Aseem Setia, Sankha Bhattacharya and Amaiyya Agrawal
INTRODUCTION .......................................................................................................................... 46
LNCRNA IN COLORECTAL CANCER .................................................................................... 49
HOTAIR .......................................................................................................................................... 50
H19 .......................................................................................................................................... 52
MALAT 1 ............................................................................................................................... 54
INVOLVEMENT OF LNCRNAS IN CRC PATHOGENESIS ................................................. 55
Wnt/β-Catenin Pathway .......................................................................................................... 56
EGFR/IGF-IR SIGNALING (PI3K AND KRAS PATHWAYS) ............................................... 59
TGF-Β SIGNALING PATHWAY ................................................................................................ 60
P53. PATHWAY ............................................................................................................................. 60
EMT PROGRAM ........................................................................................................................... 61
DETAIL DISCUSSION OF EXPERIMENTAL DATA CONDUCTED FOR
COLORECTAL CANCER (CRC) ............................................................................................... 61
lncRNA Overexpression TGF-β1 Downregulation by NLIPMT Inhibits Colorectal Cancer
Cell Migration and Invasion ................................................................................................... 61
The Activation of KPNA3 by LncRNA DLEU1 Leads to the Advancement of Colorectal
Cancer ..................................................................................................................................... 62
CONCLUSION ............................................................................................................................... 63
ABBREVIATIONS ......................................................................................................................... 63
CONSENT FOR PUBLICATION ................................................................................................ 64
CONFLICT OF INTEREST ......................................................................................................... 64
ACKNOWLEDGEMENTS ........................................................................................................... 64
REFERENCES ............................................................................................................................... 64
CHAPTER 7 PATHWAYS IN COLORECTAL CANCER ............................................................. 71
Ajay Madrewar, Kapil Gore and Sankha Bhattacharya
INTRODUCTION .......................................................................................................................... 71
CHROMOSOMAL INSTABILITY PATHWAY ........................................................................ 71
Adenomatous Polyposis Coli gene and wnt Signaling Pathway ............................................ 72
TP-53 Mutation ....................................................................................................................... 72
18q Loss of Heterozygosity (LOH) ........................................................................................ 72
MICROSATELLITE INSTABILITY PATHWAY .................................................................... 73
EPIGENETIC INSTABILITY AND CPG METHYLATION ................................................... 73
PI3K/AKT PATHWAY, PTEN, AND TGFΒR2 ......................................................................... 74
SIGNALLING PATHWAYS IN COLORECTAL CANCER .................................................... 75
EGFR/MAPK Signaling Pathway ........................................................................................... 75
Notch Signaling Pathway ........................................................................................................ 75
PI3K Signaling Pathway ......................................................................................................... 76
TGF-βsignalling Pathway ....................................................................................................... 77
Wnt Pathway ........................................................................................................................... 78
CONCLUSION ............................................................................................................................... 79
CONSENT FOR PUBLICATION ................................................................................................ 79
CONFLICT OF INTEREST ......................................................................................................... 79
ACKNOWLEDGEMENTS ........................................................................................................... 79
REFERENCES ............................................................................................................................... 79
CHAPTER 8 RADIOTHERAPY IN COLORECTAL CANCER .................................................... 81
Amit Page, Dnyanesh Saindane and Sankha Bhattacharya
INTRODUCTION .......................................................................................................................... 81
TYPES OF RADIATION THERAPY .......................................................................................... 82
CLINICAL TRIALS OR RESEARCH STUDIES OF RADIATION AND CHEMO-
RADIATION THERAPY IN COLORECTAL CANCER ......................................................... 83
Neoadjuvant Radiation Therapy ............................................................................................. 86
Probable Side Effects of Radiotherapy ................................................................................... 86
CONCLUSION ............................................................................................................................... 87
CONSENT FOR PUBLICATION ................................................................................................ 87
CONFLICT OF INTEREST ......................................................................................................... 87
ACKNOWLEDGEMENTS ........................................................................................................... 87
REFERENCES ............................................................................................................................... 87
CHAPTER 9 SURVEILLANCE FOR COLORECTAL CANCER ................................................. 90
Saurabh Maru, Kapil Gore and Sankha Bhattacharya
INTRODUCTION .......................................................................................................................... 90
COLONOSCOPY ........................................................................................................................... 91
FLEXIBLE SIGMOIDOSCOPY .................................................................................................. 92
CONCLUSIONS ............................................................................................................................. 93
CONSENT FOR PUBLICATION ................................................................................................ 93
CONFLICT OF INTEREST ......................................................................................................... 93
ACKNOWLEDGEMENTS ........................................................................................................... 93
REFERENCES ............................................................................................................................... 93
CHAPTER 10 RECENT THERANOSTICS IN TREATMENT OF COLORECTAL CANCER 95

Shilpa Dawre, Ajay Madrewar and Sankha Bhattacharya
INTRODUCTION .......................................................................................................................... 95
NANOFLATFORMS FOR DRUG DELIVERY AND THERANOSTICS ............................... 96
NANOLIPOSOMAL BASED THERANOSTIC NANOPARTICLES ...................................... 97
Prodrug Approach ................................................................................................................... 98
SUPER MAGNETIC IRON-OXIDE NANOPARTICLES (SPIONS) ...................................... 99
CONCLUSION ............................................................................................................................... 100
CONSENT FOR PUBLICATION ................................................................................................ 100
CONFLICT OF INTEREST ......................................................................................................... 100
ACKNOWLEDGEMENTS ........................................................................................................... 101
REFERENCES ............................................................................................................................... 101
CHAPTER 11 MANAGEMENT OF COLORECTAL CANCER ................................................... 103
Sankha Bhattacharya, Amit Page, Saurabh Maru and Shilpa Dawre
MANAGEMENT OF COLORECTAL CANCER ...................................................................... 103
HOW CAN YOU PREPARE PATIENTS FOR SURGERY? .................................................... 104
Enhanced Recovery After Surgery (ERAS) ........................................................................... 104
Stomal Therapy ....................................................................................................................... 104
Bowel Preparation ................................................................................................................... 104
Nutritional Interventions ......................................................................................................... 105
LOCAL RECTAL TREATMENT OF RECTAL CANCER (CLINICS IN THE COLON A
RECTAL) ........................................................................................................................................ 105
Tumor Evaluation ................................................................................................................... 105
Electrocoagulation .................................................................................................................. 106
Contract Radiotherapy ............................................................................................................ 107
Local Excision ........................................................................................................................ 107
ENDOSCOPIC TREATMENT ..................................................................................................... 108
Snare Polypectomy ................................................................................................................. 108
Endoscopic Mucosal Resection (EMR) .................................................................................. 108
Endoscopic Submucosal Dissection ....................................................................................... 109
WHAT IS THE SURGICAL OPTION FOR COLORECTAL CANCER? .............................. 109
Open Surgery .......................................................................................................................... 109
Laparoscopic Surgery ............................................................................................................. 110
WHAT ARE POSSIBLE COMPLICATIONS? .......................................................................... 110
Immediate ............................................................................................................................... 110
Long Term .............................................................................................................................. 110
WHAT IS THE ROLE OF ADJUVANT CHEMOTHERAPY IN COLORECTAL
CANCER TREATMENT? ............................................................................................................ 111
CONCLUSION ............................................................................................................................... 111
CONSENT FOR PUBLICATION ................................................................................................ 112
CONFLICT OF INTEREST ......................................................................................................... 112
ACKNOWLEDGEMENTS ........................................................................................................... 112
REFERENCES ............................................................................................................................... 112
SUBJECT INDEX .................................................................................................................................... 115