Gastrointestinal cancers: 60,000 new cases a year; treatment is shifting its approach and objectives
For many years, treatment was based on the site of the disease, such as the stomach, colon and liver. Today, the focus is on biological characteristics and response to treatment
Treatment for gastrointestinal cancers is undergoing a profound change. For many years, treatment was based on the site of the disease: the stomach, colon, liver, bile ducts or pancreas. Today, that is no longer enough. The nature of the tumour, its biological characteristics and how it responds to treatment are also important factors.
This is the shift in approach discussed at the “Lazio Network: Breaking News and Real-Life in Gastrointestinal Cancers”, organised by the IRCCS Regina Elena National Cancer Institute (IRE) and the Latina Local Health Authority (ASL). The event, now in its second year, brought together over sixty specialists from the region’s leading centres in Rome.
New diagnoses
The figures highlight the significance of this issue: in Italia, gastrointestinal cancers account for over 60,000 new diagnoses every year. Colorectal cancer is the most common, with an estimated 41,700 new cases in 2025, followed by stomach cancer (14,700) and gastrointestinal stromal tumours (around 900). For colorectal cancer, the five-year survival rate stands at 64.2 per cent.
The first major development is molecular profiling: studying the tumour in depth to identify alterations in its DNA that guide treatment choices. Tumours of the stomach and bile ducts, which until a few years ago were difficult to treat with personalised approaches, are becoming increasingly ‘readable’ diseases. Identifying a specific mutation allows for the use of targeted drugs: it is like finding the right lock, rather than demolishing the whole building. At the IRE, clinical trials are getting underway for patients with molecularly positive colorectal cancer.
Patients with advanced disease
A second area of focus concerns patients with advanced disease, particularly hepatocellular carcinoma and cholangiocarcinoma, where the role of combining systemic therapies with locoregional treatments – including TARE (transarterial radioembolisation) – is growing. This technique involves injecting microspheres loaded with radioactive material into the artery supplying the tumour, delivering radiotherapy directly to the tumour mass. It has been performed at the IFO since 2004: over 1,500 treatments have been carried out, of which more than 1,000 were in patients with hepatocellular carcinoma.
