Neoadjuvant treatment of rectal cancer

Hideghéty Katalin (1,2), Maráz Anikó (1), Együd Zsófia (1)
(1) Szegedi Tudományegyetem, Onkoterápiás Klinika, Szeged
(2) ELI-ALPS Non-profit Kft.

The evolution of complex treatment approaches for loco-regionally advanced rectal carcinomas is a prime example of the successful application of logically sequenced, well-designed clinical trial results. Over the past 50 years, particularly in the last decade, advancements in modern imaging, pathology and molecular diagnostics, along with surgical, radiotherapy and systemic therapy techniques, and the optimization of interdisciplinary collaboration have led toa doubling of survival rates and a tripling of sphincter preservation. Additionally, the number of patients in complete remission who avoid surgery and are under close monitoring is steadily increasing. Changes in the sequencing of previous treatment modalities, such as the introduction of various combinations of chemotherapy and radiotherapy in the neoadjuvant setting, and new strategies like neoadjuvant immunotherapy for patients with highly microsatellite-unstable colorectal tumors (those deficient in mismatch repair enzymes [MMRd]), have transformed treatment paradigms for these patients. Minimally invasive surgical techniques, selective radiotherapy approaches, and new, effective, targeted systemic treatments, along with modern supportive care have also contributed to significant improvements in patients‘ quality of life.

In this summary, we review the development of neoadjuvant therapies for locally advanced rectal cancer, exploring the variations and efficacy of total neoadjuvant treatments based on the latest clinical trials. We also provide an overview of the research steps that have led to current neoadjuvant alternatives and look ahead to emerging trends based on ongoing studies and developments.


Kapcsolódó cikkek