4.6 Review

Current status of locally advanced rectal cancer therapy and future prospects

Related references

Note: Only part of the references are listed.
Review Immunology

Cancer organoid co-culture model system: Novel approach to guide precision medicine

Jin Yuan et al.

Summary: Three-dimensional cancer organoids derived from self-organizing cancer stems faithfully mimic the structure, features, and genetic signatures of tumors. Co-culture models involving immune cells or fibroblasts provide a means to investigate the tumor microenvironment and molecular interactions, potentially benefiting cancer research and precision medicine. However, the lack of a complete tumor microenvironment remains a major limitation that needs to be addressed for further improvements.

FRONTIERS IN IMMUNOLOGY (2023)

Review Oncology

A Review of Circulating Tumor DNA as a Biomarker Guide for Total Neoadjuvant Therapy in Patients with Locally Advanced Rectal Cancer

Jehan Yahya et al.

Summary: Non-operative management is a popular approach for locally advanced rectal cancer patients with no evidence of disease after neoadjuvant therapy, but high recurrence rates and distant metastases have emphasized the urgent need for robust biomarker strategies. This review summarizes recent advances in the use of cell-free (cf) and circulating tumor (ct) DNA as potential biomarkers to guide non-operative management strategies for LARC patients.

JOURNAL OF GASTROINTESTINAL CANCER (2023)

Article Oncology

Patient-derived tumor organoids predict responses to irinotecan-based neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer

Tao Lv et al.

Summary: Adding irinotecan to neoadjuvant chemoradiotherapy in locally advanced rectal cancer can increase the pathologic complete response rate but also lead to more toxicities. Patient-derived tumor organoids (PDTOs) can predict the sensitivity to irinotecan and the treatment response and survival outcomes.

INTERNATIONAL JOURNAL OF CANCER (2023)

Article Surgery

Locoregional Failure During and After Short-course Radiotherapy Followed by Chemotherapy and Surgery Compared With Long-course Chemoradiotherapy and Surgery

Esmee A. Dijkstra et al.

Summary: This study analyzed the risk and patterns of locoregional failure (LRF) in patients of the RAPIDO trial. The results showed that total neoadjuvant treatment (TNT), while increasing the risk of locoregional recurrence (LRR), can still reduce disease-related treatment failure and distant metastases after 5 years.

ANNALS OF SURGERY (2023)

Article Oncology

Circulating tumor DNA detection after neoadjuvant treatment and surgery predicts recurrence in patients with early-stage and locally advanced rectal cancer

Lisa S. M. Hofste et al.

Summary: This study evaluated the role of circulating tumor DNA (ctDNA) in assessing disease after neoadjuvant therapy and surgery to optimize treatment choices. The results showed that the detection of ctDNA after neoadjuvant therapy and surgery was associated with poor progression-free survival. This suggests that the detection of ctDNA may be helpful in predicting treatment response and prognosis in patients with early-stage and locally advanced rectal cancer.
Article Oncology

Cancer statistics, 2022

Rebecca L. Siegel et al.

Summary: Each year, the American Cancer Society compiles data on cancer occurrence and outcomes in the United States. The latest data shows that breast and prostate cancer progress has stagnated, while lung cancer has shown improvements in survival rates. Lung cancer incidence for advanced disease has declined while localized-stage rates have increased, resulting in higher survival rates. Mortality patterns align with incidence trends, with lung cancer deaths declining rapidly, breast cancer deaths slowing, and prostate cancer deaths stabilizing.

CA-A CANCER JOURNAL FOR CLINICIANS (2022)

Article Gastroenterology & Hepatology

Oxaliplatin-based adjuvant chemotherapy rather than fluorouracil-based chemotherapy in rectal cancer is more efficient to decrease distant metastasis and increase survival after preoperative chemoradiotherapy and surgery: a meta-analysis

Jin Ho Song et al.

Summary: The addition of oxaliplatin to adjuvant therapy for stage II-III rectal cancer following preoperative CRT and TME may increase disease-free survival without significant increases in toxicity, but not overall survival.

INTERNATIONAL JOURNAL OF COLORECTAL DISEASE (2022)

Meeting Abstract Oncology

Phase II study of durvalumab following neoadjuvant chemoRT in operable rectal cancer: NSABP FR-2

Thomas J. George et al.

JOURNAL OF CLINICAL ONCOLOGY (2022)

Review Biochemistry & Molecular Biology

Tumor draining lymph nodes, immune response, and radiotherapy: Towards a revisal of therapeutic principles

Michael Koukourakis et al.

Summary: Tumor-draining lymph nodes (TDLNs) are crucial sites for anti-tumor immune responses. Radiotherapy can enhance the release of tumor antigens and activate the interferon type-I pathway, promoting the development of a 'radio-vaccination' effect. However, irradiation may also deplete immune cells in TDLNs, compromising immune response and treatment effectiveness. Re-evaluation and interventions to preserve and handle the functional state of TDLNs or other lymph nodes may have therapeutic importance.

BIOCHIMICA ET BIOPHYSICA ACTA-REVIEWS ON CANCER (2022)

Review Oncology

Liquid biopsies to monitor and direct cancer treatment in colorectal cancer

Gianluca Mauri et al.

Summary: Colorectal cancer is a prevalent and deadly cancer, and there is a clinical need for better patient selection for systemic treatments. Genotyping circulating tumour DNA is a potential method to personalize treatment and overcome limitations of traditional biopsy approaches. This review summarizes the evidence of ctDNA applicability in colorectal cancer and discusses ongoing clinical trials.

BRITISH JOURNAL OF CANCER (2022)

Article Oncology

Multicenter, Randomized, Phase III Trial of Short-Term Radiotherapy Plus Chemotherapy Versus Long-Term Chemoradiotherapy in Locally Advanced Rectal Cancer (STELLAR)

Jing Jin et al.

Summary: This study aimed to compare the efficacy of preoperative short-term radiotherapy followed by chemotherapy with a standard schedule of long-term chemoradiotherapy in patients with locally advanced rectal cancer. The results showed that the short-term radiotherapy and chemotherapy regimen was non-inferior to the standard regimen in terms of 3-year disease-free survival and had better overall survival.

JOURNAL OF CLINICAL ONCOLOGY (2022)

Article Oncology

Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy

Julio Garcia-Aguilar et al.

Summary: This study demonstrates that organ preservation is achievable in patients with locally advanced rectal cancer treated with total neoadjuvant therapy, without a decrease in survival.

JOURNAL OF CLINICAL ONCOLOGY (2022)

Review Oncology

The Prognostic Importance of ctDNA in Rectal Cancer: A Critical Reappraisal

Edina Dizdarevic et al.

Summary: An individualized treatment approach is crucial for improving survival and quality of life in rectal cancer, with circulating tumor DNA (ctDNA) showing promise as a useful tool for stratifying patients. However, current results are conflicting and lack standardization, highlighting the need for further studies to address bias and heterogeneity in reporting. Despite an association between ctDNA status and outcome, the field of research is still new with limited dedicated studies, underscoring the importance of standardization in ctDNA research for future advancements.

CANCERS (2022)

Article Medicine, General & Internal

PD-1 Blockade in Mismatch Repair-Deficient, Locally Advanced Rectal Cancer

Andrea Cercek et al.

Summary: This study found that mismatch repair-deficient, locally advanced rectal cancer is highly sensitive to PD-1 blockade. Additionally, no adverse events of grade 3 or higher have been reported, and no cases of progression or recurrence have been observed. Longer follow-up is needed to assess the duration of response.

NEW ENGLAND JOURNAL OF MEDICINE (2022)

Article Oncology

Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial

Renu R. Bahadoer et al.

Summary: The RAPIDO trial aimed to reduce systemic relapses in locally advanced rectal cancer through short-course radiotherapy, chemotherapy, and delayed surgery. Results showed a decreased probability of disease-related treatment failure in the experimental group compared to standard care, with diarrhea being the most common adverse event and neurological toxicity being prominent in the standard care group during adjuvant chemotherapy.

LANCET ONCOLOGY (2021)

Article Oncology

Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

Hyuna Sung et al.

Summary: The global cancer burden in 2020 saw an estimated 19.3 million new cancer cases and almost 10.0 million cancer deaths. Female breast cancer surpassed lung cancer as the most commonly diagnosed cancer, while lung cancer remained the leading cause of cancer death. These trends are expected to rise in 2040, with transitioning countries experiencing a larger increase compared to transitioned countries due to demographic changes and risk factors associated with globalization and a growing economy. Efforts to improve cancer prevention measures and provision of cancer care in transitioning countries will be crucial for global cancer control.

CA-A CANCER JOURNAL FOR CLINICIANS (2021)

Editorial Material Gastroenterology & Hepatology

Tailored total neoadjuvant therapy for locally advanced rectal cancer: One size may not fit for all!

Leyla Ozer et al.

Summary: Current neoadjuvant protocols have benefits for local control in most patients with locally advanced rectal cancer. However, total neoadjuvant therapy requires further advances to address uncertainties such as patient selection criteria and the optimal sequence and type of chemotherapy and radiotherapy.

COLORECTAL DISEASE (2021)

Article Oncology

Phase II, single-arm trial of preoperative short-course radiotherapy followed by chemotherapy and camrelizumab in locally advanced rectal cancer

Zhenyu Lin et al.

Summary: The study found that preoperative short-course radiotherapy combined with CAPOX and camrelizumab followed by delayed surgery showed a favorable pathological complete response rate in locally advanced rectal cancer patients, especially in proficient MMR tumors.

JOURNAL FOR IMMUNOTHERAPY OF CANCER (2021)

Article Oncology

Neoadjuvant chemotherapy with FOLFIRINOX and preoperative chemoradiotherapy for patients with locally advanced rectal cancer (UNICANCER-PRODIGE 23) : a multicentre, randomised, open-label, phase 3 trial

Thierry Conroy et al.

Summary: In patients with cT3 or cT4 M0 rectal cancer, intensifying chemotherapy with FOLFIRINOX before preoperative chemoradiotherapy significantly improved disease-free survival outcomes and reduced neurotoxicity. Thus, the PRODIGE 23 results have the potential to impact clinical practice.

LANCET ONCOLOGY (2021)

Review Gastroenterology & Hepatology

An update on the use of immunotherapy in patients with colorectal cancer

Mike Nguyen et al.

Summary: Immunotherapy has become a standard of care for some CRC patients with MSI. While overall survival data are still pending, the promise of profound and durable responses is highly anticipated. The lack of efficacy in MSS CRC is disappointing and strategies to convert these 'cold' tumors are needed.

EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY (2021)

Review Oncology

Neoadjuvant Chemotherapy in Locally Advanced Rectal Cancer

Federica Papaccio et al.

CANCERS (2020)

Review Oncology

Integrating liquid biopsies into the management of cancer

Giulia Siravegna et al.

NATURE REVIEWS CLINICAL ONCOLOGY (2017)

Article Biochemistry & Molecular Biology

Systemic Immunity Is Required for Effective Cancer Immunotherapy

Matthew H. Spitzer et al.

Article Medicine, General & Internal

The life and legacy of William Ernest Miles (1869-1947): a tribute to an admirable surgeon

Fábio Guilherme Campos

Revista da Associacao Medica Brasileira (2013)

Article Oncology

BEVACIZUMAB, CAPECITABINE, AMIFOSTINE, AND PREOPERATIVE HYPOFRACTIONATED ACCELERATED RADIOTHERAPY (HYPOARC) FOR RECTAL CANCER: A PHASE II STUDY

Michael I. Koukourakis et al.

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS (2011)

Article Oncology

Wait-and-See Policy for Clinical Complete Responders After Chemoradiation for Rectal Cancer

Monique Maas et al.

JOURNAL OF CLINICAL ONCOLOGY (2011)

Article Oncology

PHASE II TRIAL OF NEOADJUVANT BEVACIZUMAB, CAPECITABINE, AND RADIOTHERAPY FOR LOCALLY ADVANCED RECTAL CANCER

Christopher H. Crane et al.

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS (2010)

Article Medicine, General & Internal

Chemotherapy with preoperative radiotherapy in rectal cancer

Jean-Francois Bosset et al.

NEW ENGLAND JOURNAL OF MEDICINE (2006)

Article Medicine, General & Internal

Preoperative versus postoperative chemoradiotherapy for rectal cancer

R Sauer et al.

NEW ENGLAND JOURNAL OF MEDICINE (2004)

Article Medicine, General & Internal

Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer

E Kapiteijn et al.

NEW ENGLAND JOURNAL OF MEDICINE (2001)