UK clinical trials - updated daily from ClinicalTrials.gov
Find clinical trials for colorectal (bowel) cancer in the United Kingdom. Explore treatment pathways from early stage to metastatic disease.
Colorectal cancer is the fourth most common cancer in the UK, with ~43,000 new cases yearly. It affects the large bowel (colon) and rectum. Survival has improved significantly - over half of patients now survive 10 years or more, thanks to earlier detection through the NHS bowel screening programme and advances in treatment including targeted therapies and immunotherapy.
Every metastatic colorectal cancer patient should have biomarker testing. Key markers: RAS mutations (KRAS, NRAS - ~45%, determines anti-EGFR therapy eligibility), BRAF V600E (~8%, poor prognosis but responds to encorafenib + cetuximab), MSI-H/dMMR (~5%, responds to immunotherapy like pembrolizumab), and HER2 amplification (~3%, may benefit from trastuzumab + pertuzumab). NICE recommends testing for all of these before starting treatment.
Early stage: surgery ± adjuvant chemotherapy. Metastatic: first-line combines chemotherapy (FOLFOX or FOLFIRI) with targeted therapy - anti-EGFR (cetuximab) for RAS wild-type, anti-VEGF (bevacizumab) for RAS mutant. Second-line switches chemotherapy backbone. For MSI-H tumours, immunotherapy (pembrolizumab or nivolumab) is now first-line. Third-line options include trifluridine-tipiracil, regorafenib, and fruquintinib.
The UK is a major hub for colorectal cancer research. Active trial areas: next-generation antibody-drug conjugates, novel immunotherapy combinations, cancer vaccines targeting neoantigens, liquid biopsy-guided treatment, and organoid-based precision medicine. The NHS bowel screening programme continues to drive earlier detection, and trials are exploring AI-assisted colonoscopy.
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