Clinical Trial Aims to Find Better Treatment Option for Rare Small Bowel Cancer

The small intestine, also called the small bowel, plays a key role in digestion, helping break down food and absorbing nutrients.    

A 2019 study found that over the previous 40 years, the number of cases of small bowel cancers more than doubled.  

Despite this, small bowel cancers are still considered rare in the U.S. Statistics from the American Cancer Society show that they account for less than 1 in 10 cancers that occur in the gastrointestinal tract and less than 1 in 100 cancers in general.   

Adenocarcinoma — a cancer that starts in the glandular cells that line the small intestine — is the most common type of small bowel cancer. The Gastrointestinal Oncology Department at Moffitt Cancer Center sees three to four new patients with this malignancy each month.  

Tiago Biachi, MD, PhD

“Due to its rarity, there is no standard treatment for this disease,” Tiago Biachi, MD, PhD, a gastrointestinal oncologist at Moffitt said. “Because of molecular similarities, we tend to use chemotherapy regimens used in colon cancer to treat these patients. But, due to its aggressive behavior, a more effective treatment regimen is urgently needed.” 

This need triggered Biachi to develop a clinical trial specifically focused on small bowel adenocarcinoma.  

The trial will consist of 36 patients with unresectable or metastatic small bowel adenocarcinoma who have not received prior treatment. Before enrolling, each patient will be analyzed to determine if a novel systemic therapy regimen will benefit their treatment plan. The patients will be treated with a combination chemotherapy regimen, recently approved by the U.S. Food and Drug Administration to treat pancreatic cancer.   

“One of the drugs in this chemotherapy regimen, liposomal irinotecan, has shown promising results in pre-clinical models,” Biachi said.  

He says this study is a step towards establishing a new standard of care for small bowel adenocarcinoma.