Allan Tsung, MD, the S. Hurt Watts Professor of Surgery and the chair of the Department of Surgery, was awarded a 5-year, $2 million grant from NIH to study how exercise therapy before cancer surgery can improve outcomes of patients.
Colorectal cancer is a devastating cause of mortality worldwide, with the majority of patients dying as a result of metastases to the liver. When feasible, resection of hepatic metastases provides improved survival; however, hepatic recurrence after surgical resection occurs in over 60% of patients and is the major cause of treatment failure. Recurrence after “curative” surgery of primary tumors and, even more so, after tumor reductive surgery of liver metastases is mainly due to growth of occult micro-metastases or dissemination of tumor cells after excision.
Dr. Tsung’s research team seeks to understand the significant mechanisms in surgery-induced metastasis to facilitate developing new targeted treatment modalities during the perioperative window. One such perioperative treatment is pre-operative exercise therapy. It is known that exercise confers beneficial effects on cancer outcomes by regulating multiple mechanisms, including alteration of quantity and function of immune cells in the tumor microenvironment. By reducing inflammatory responses from surgery, pre-operative exercise therapy can help sustain an anti-tumor immune microenvironment in the liver. This project will identify pre-operative exercise-induced transcriptional signatures in the local tumor immune microenvironment for the first time, which will be valuable to identifying potential pharmaceutical targets in colorectal cancer metastasis. These findings will provide the intellectual framework for devising new exercise therapies that are mechanism-based and effective in improving surgical outcomes of cancer patients.