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New NCI grant will support Jefferson trial to study test to diagnose colorectal cancer spread

if disease spread to the lymph nodes and then follow those patients to see how they do clinically during the next five years.

"We expect to find the GCC-RT-PCR analysis will identify patients who have tiny amounts of cancer in the lymph nodes that were undetected by histopathology," he says. "The pathology will be done in parallel with testing for GCC. We believe that the patients who are histopathology negative but GCC positive will do worse in terms of clinical progression - they will develop recurrent disease that was missed the first time."

In a previous trial, Dr. Waldman and his Jefferson co-workers examined 21 colorectal cancer patients. One group of 11 patients had been disease-free for at least six years and deemed "cured." The other group of 10 patients developed recurrent disease within three years after cancer surgery. The latter had been told initially that they had no signs of cancer in their lymph nodes after surgery, meaning their cancer had not spread.

When pathologists examined lymph node samples of each patient for the presence of GCC, they found the disease-free patients' lymph nodes showed no signs of the marker. Conversely, GCC was present in every patient whose cancer had returned.

"The earlier trial was on a small scale, and until you do this [larger] trial, you really can't be sure if testing for GCC is as good as it appears," he says. "This is a prospective trial in which patients are staged and then we see how they do. In the past, the study was retrospective - we knew what happened to the patient. There's no bias in this trial - we don't know what will happen."

Dr. Waldman isn't sure that one marker will necessarily catch all colorectal cancer that has spread elsewhere in the body, noting eventually, a panel of markers may be used. "We think GCC represents an order of improvement over what is done now. Perhaps adding other markers will make it even better."

To participate in the trial, a patient must have a
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Contact: Steve Benowitz
steven.benowitz@mail.tju.edu
215-955-5291
Thomas Jefferson University
20-Jun-2002


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