Colorectal cancer is the second leading cause of cancer death in the US with 60,000 deaths and about 150,000 patients diagnosed annually. Worldwide, there are about 1,023,000 new cases and 530,000 deaths occur annually due to this cancer. The colon cancer drugs market worldwide is estimated to be about $ 4 billion.

Dr Richard Goldberg, a world renowned expert in oncology told Pharmabiz in an exclusive interview, during his visit to Hyderabad on Thursday, industry and research institutions have been establishing collaborations to conduct research on colorectal cancer to find new methods of treatment and develop new drugs, in the US. University of North Carolina for instance has collaborations with about 60 pharma companies. Hundreds of trials are being carried out in the US. Many trials are carried out in collaboration as Government actively funds such initiatives. Research institutions help pharma companies in answering to FDA queries. Drug development for colorectal cancer is on the portfolio of almost all the pharma companies in the US.

He said, combination chemotherapy with biologics has more than doubled median survival. Resection of oligo-metastatic disease may provide cure or afford long-term disease-free survival. All patients should be assessed for respectability at diagnosis and re-staging. Elderly patients benefit equally from aggressive chemotherapy with minimal increase in toxicity.

Dr Richard Goldberg is currently professor of medicine with the University of North Carolina and is the chief of the Division of Haematology and Oncology, and the physician-in-chief of the North Carolina Cancer Hospital. The hospital handles 300 new cases every year. Patients flow from US, Canada and other countries to undergo treatment. He has special interest in colorectal cancer, chemotherapy, cancer genetics, developmental therapeutics and clinical trial design.

He said, in the next 10 years, about 10-15 new drugs may hit the market in the area of colorectal cancer. As of now there are six FDA approved drugs available in the market. There can be a replacement for chemotherapy, some day. Chemotherapy has several side effects, and this makes companies to look at targeted therapies that succeed in targeting only the abnormal cells. An ideal combination is using two chemotherapy drugs and one biological.

India too can have a large incidence of colon cancer cases. Early detection through advanced diagnostic technologies can restrict the patients from reaching late stage of cancer. As Indians move from traditional Indian diet to newer food culture, they get prone to colorectal cancers. Worldwide, it is found that genetics (inherited and acquired) has been one of the responsible factors for colon cancer. Thus, several companies globally are looking at personalised medicines as genetics affect each individual differently. Pharmaco genetics is also widely getting recognised in the US, Dr Richard added.

Dr Richard is the president elect of International Society of Gastrointestinal Oncology, which is striving for faster discussion among medical experts on fighting the cancer. He has been involved in clinical research and education with various renowned institutes and groups including mayo Clinic, Lineberger Comprehensive Cancer Centre, North Central Cancer Treatment Group and eastern Cooperative Oncology Group.

His research work is primarily focused on GI cancers, principally colorectal cancer and is actively involved in the new cancer drug and drug combinations development, as well as clinical trials methodology. He is the principal investigator of National Intergroup Study N9741, an international phase III study of oxaliplatin, irinotecan and 5-fluorouracil in combinations for the first-line treatment of advanced colorectal cancer.