Treatment of Locally Advanced/Metastatic Colorectal Cancer

Few treatment advances have been observed in recent years for the treatment of advanced colorectal cancer (CRC). The goal remains to find approaches beyond FOLFOX and bevacizumab that will prolong remission. Immunotherapy for patients with microsatellite instability-high tumors represents progress, but this is a very small subset and approximately 30% of patients will not experience response. In locally advanced CRC, good long-term outcomes and manageable toxicity are being achieved with contemporary treatment strategies. Total neoadjuvant therapy, which incorporates induction or consolidation chemotherapy, has improved the treatment of patients with rectal cancer and is now a standard of care, although optimal sequencing is still being debated. Nonoperative management is an emerging option for sphincter preservation, and ongoing studies are evaluating the omission of radiation in select patients.

Automated summary

Advances in the treatment of advanced colorectal cancer have been slow in recent years, with a focus on finding new approaches beyond traditional methods. Locally advanced colorectal cancer patients are achieving good long-term outcomes with contemporary treatment strategies, and total neoadjuvant therapy has shown significant improvements in the treatment of rectal cancer patients.