Recent findings from a bowel cancer trial led by University College London (UCL) and University College London Hospital (UCLH) offer genuinely encouraging news at a time when bowel cancer rates continue to rise, including among younger adults.

What did the bowel cancer trial show?

The trial, known as NEOPRISM-CRC, explored a different treatment pathway for patients with stage two or three bowel cancer. Instead of the standard approach of surgery followed by chemotherapy, patients received a short course of immunotherapy before surgery.

Initial results indicated that 59% of patients had no signs of disease after immunotherapy, before their planned bowel cancer operation.

After nearly three years of follow up, none of the patients involved in the trial experienced a return of their cancer. This includes those who had no signs of cancer after treatment and those who still had small amounts remaining.

This is striking when compared with standard treatment outcomes, where around one in four patients typically see their cancer return within three years following surgery and chemotherapy.

Although the trial involved only a limited number of patients, the absence of relapses at the follow up stage suggests that pre-surgery immunotherapy may offer more durable cancer control for certain patients.

The role of genetics and personalised treatment

It is important to note that this trial is limited to patients with a specific genetic profile, which only accounts for around 10–15% of stage two and three bowel cancer patients. Researchers are now exploring whether similar approaches could benefit patients with other genetic profiles. They are also considering how personalised blood tests may help identify who is most likely to respond well to immunotherapy before surgery.

This reflects a wider shift in cancer care by moving away from a “one size fits all” approach towards treatments that takes individual biology into account.

Why these results matter

Bowel cancer remains one of the most common cancers in the UK, with around 44,000 cases diagnosed each year. While it is still more common in older adults, cases in those under 50 have been increasing over recent decades.

For many patients, standard bowel cancer treatment of surgery followed by chemotherapy can be physically and emotionally challenging. The new treatment pathway raises the possibility of avoiding chemotherapy, along with its associated side effects.

The prospect of reducing relapse rates is hugely significant, and can mean improved survival, better quality of life and less long term physical harm from intensive treatments.

The importance of early diagnosis

The study, which was effective in patients with stages 2 or 3 bowel cancer, highlights that early detection is still key.

As clinical negligence solicitors, many of the cases we see involve delays in recognising symptoms, misinterpretation of test results or failures to refer patients for urgent investigation. Advances in treatment can only benefit patients if cancer is diagnosed in time and if individuals are given access to the right treatment pathways.

This trial does not mean that immunotherapy before surgery is suitable for everyone. However, the results have the potential to significantly improve life expectancy and quality of life for a vast number of patients.

At a time when bowel cancer diagnoses are increasing among those under 50, developments like this serve as a reminder of why continued investment in cancer research, early diagnosis and high standards of care remain vital. It is encouraging to see these advancements working.

Katie Nolan has recently posted an article for Bowel Cancer Awareness Month addressing the signs and symptoms. We would encourage everyone to familiarise themselves with these so that they can spot the symptoms and advocate for themselves.