Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Advancing Personalized Medicine in the Treatment of Locally Advanced Rectal Cancer

Francesco Giulio Sullo
,
Alessandro Passardi
* ORCID logo ,
Chiara Gallio
,
Chiara Molinari
ORCID logo ,
Giorgia Marisi
ORCID logo ,
Eleonora Pozzi
ORCID logo ,
Leonardo Solaini
,
Alessandro Bittoni
Version 1 : Received: 20 March 2024 / Approved: 20 March 2024 / Online: 20 March 2024 (16:08:21 CET)

A peer-reviewed article of this Preprint also exists.

Sullo, F.G.; Passardi, A.; Gallio, C.; Molinari, C.; Marisi, G.; Pozzi, E.; Solaini, L.; Bittoni, A. Advancing Personalized Medicine in the Treatment of Locally Advanced Rectal Cancer. J. Clin. Med. 2024, 13, 2562. Sullo, F.G.; Passardi, A.; Gallio, C.; Molinari, C.; Marisi, G.; Pozzi, E.; Solaini, L.; Bittoni, A. Advancing Personalized Medicine in the Treatment of Locally Advanced Rectal Cancer. J. Clin. Med. 2024, 13, 2562.

Abstract

Rectal cancer presents a significant burden globally, often requiring multimodal therapy for locally advanced cases. Long-course chemoradiotherapy (LCRT) and short-course radiotherapy (SCRT) followed by surgery have been conventional neoadjuvant approaches. Recent trials favor LCRT due to improved local control. However, tumor distant recurrence remains a concern, prompting exploration of Total Neoadjuvant Therapy (TNT) as a comprehensive treatment strat-egy. Immune checkpoint inhibitors (ICIs) show promise, particularly in mismatch repair-deficient (dMMR) or microsatellite instability-high (MSI-H) tumors, potentially revolutionizing neoadjuvant regimens. Non-operative management (NOM) represents a viable alternative post-neoadjuvant therapy for selected patients achieving clinical complete response (cCR). Additionally, monitoring minimal residual disease (MRD) using circulating tumor DNA (ctDNA) emerges as a non-invasive method for treatment response assessment. This review synthesizes current evidence on TNT, ICIs, NOM and ctDNA, elucidating their implications for rectal cancer management and highlighting avenues for future research and clinical application.

Keywords

rectal cancer; total neoadjuvant treatment; immunocheckpoint inhibitors; nonoperative management; ctDNA.

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download PDF

Comments (0)

We encourage comments and feedback from a broad range of readers. See criteria for comments and our Diversity statement.

Leave a public comment
Send a private comment to the author(s)
* All users must log in before leaving a comment
Views 0
Downloads 0
Comments 0
Metrics 0
Get PDF Cite Share 0
Bookmark BibSonomy Mendeley Reddit Delicious
×
Alerts
Notify me about updates to this article or when a peer-reviewed version is published.
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here.