One of our main goals in clinical research in patients with polyposis syndromes is the optimization and personalization of endoscopic surveillance to prevent cancer development and improve quality of life of our patients. In addition, we aim to unravel the colorectal cancer pathway by identifying novel driver genes responsible for progression of pre-malignant lesions.

Clinical research in familial adenomatous polyposis (FAP)

Within a large European consortium of FAP centers, established in 2019, we perform clinical studies with the goal to optimize endoscopic surveillance for patients with FAP. Currently, no personalized surveillance protocols are available for the lower GI tract. For the upper GI tract, the current Spigelman classification system showed multiple limitations.

We developed personalized surveillance and intervention protocols for lower and upper GI tract and evaluate the efficacy in a prospective registry. The main goal of this new strategy is to prevent development of cancer. However, an important secondary goal is to prevent overtreatment and thereby we aim to improve the quality of life of our patients.
In a randomized controlled trial, we besides investigate what the preferred endoscopic imaging technique is for surveillance endoscopies.

Translational research in serrated polyps

Currently Serrated Polyposis Syndrome is the most prevalent polyposis syndrome and is characterized by the presence of numerous serrated polyps in the colon. Ten years ago, a major discovery has been the malignant potential of serrated polyps. This relatively new field in colorectal cancer research is focused on unravelling the ‘serrated neoplasia pathway’.

In our project we analyze a set of resected serrated polyps with dysplasia with different techniques like immunohistochemistry, whole exome sequencing and whole genome methylation. By isolating DNA from cells of different parts of the polyp (normal, serrated, dysplasia), we aim to discover novel driver genes responsible for the progression from serrated polyp to colorectal cancer. Thus, these genes could have the potential of a new targeted (immuno-)therapy.

Amsterdam UMC researchers involved in this project: