The TEOGIC study project: a comprehensive characterization of early onset gastrointestinal cancer in the Northern area of Spain

Abstract

Gastrointestinal cancer; Environmental risk factors; Precision medicine

Cáncer gastrointestinal; Factores de riesgo ambientales; Medicina de precisión

Càncer gastrointestinal; Factors de risc ambiental; Medicina de precisió

Background Gastrointestinal cancers represent one of the most prevalent diseases worldwide. Strikingly, the incidence of Early Onset Gastrointestinal Cancer (EOGIC) has been rising during the last decades and changes in lifestyle and environmental exposure seem to play a role. EOGIC has been defined as a different entity compared to on-average gastrointestinal cancer, with distinct clinical and molecular characteristics. Inherent to the particularities of younger age, there is an unmet need for a tailored approach for the management of these patients. The TEOGIC proposes a comprehensive study to characterize EOGIC patients in the northern of Spain. Methods Patients with histologically confirmed new diagnosis of colorectal, gastroesophageal and pancreatic adenocarcinoma will be considered for two cohorts: EOGIC (≤ 50 years old) and non-EOGIC (60–75 years old), with a ratio of 1:2. Two hundred and forty patients will be recruited in 4 Public Hospitals from northern Spain. After receiving unified informed consent, demographic and clinical data of the patients will be collected in a REDCap database. Lifestyle related data will be obtained in questionnaires assessing diet, physical activity and the general quality of life of the patients before diagnosis. Biological samples prior to any onco-specific treatment will be obtained for the analyses of circulating inflammatory proteins, gut microbiota, and the proteome of the tumor microenvironment. Histologic characteristics and routine biomarkers will be also collected. Thereafter, data will be integrated and analyzed to assess tumor specific, pan-tumor and sex-associated differential characteristics of EOGIC. Discussion The underlying risk factors and differential characteristics of EOGIC remain poorly studied, particularly in our geographical area. Although limited by the exploratory nature and the small sample size estimated to be recruited, TEOGIC represents the first attempt to comprehensively characterize these young patients, and thus attend to their special needs. Findings derived from this study could contribute to raise awareness and preventive behaviors in the population. In parallel, molecular studies could lead to the identification of potential novel non-invasive biomarkers and therapeutic targets that would help in the development of the tailored clinical management of these patients, focusing on screening programs for early diagnosis and precision medicine.

The TEOGIC project has been previously scientifically peer reviewed by the Carlos III Health Institute, with a funding decision within the competitive Research Projects AES 2023 call, ref: PI23/01514. IL is financed by National Agency of Research (AEI) in the “Juan de la Cierva-Postdoctoral formación” (8FJC2021-046521-I); AL is supported by the “Clínico Junior en el Territorio AECC 2023” grant from the Spanish Association Against Cancer (AECC) (CLJUN234885LECU). HA is supported by the “Clínico Junior 2019” grant from the Spanish Association Against Cancer (AECC) (CLJUN19010ARAS); MA is partially financed by the Government of Navarra in the La Caixa Program. AMC is supported by the “AECC SEED IDEAS 2023” grant from the Spanish Association Against Cancer (AECC) and "Knowledge Generation Proyects 2022" grant from the State Scientific, Technical and Innovation Research Plan 2021—2023 from the Ministry of science, innovation and universities. Spanish government.