Total Neoadjuvant Treatment for Locally Advanced Rectal Cancer Patients: Where Do We Stand?
Valentina DapràMarco AiroldiMichela BartoliniRoberta FazioGiuseppe MondelloMaria Chiara TronconiMaria Giuseppina PreteGiuseppe D'AgostinoCaterina FoppaAntonino SpinelliAlberto PucciniArmando SantoroPublished in: International journal of molecular sciences (2023)
The therapeutic landscape in locally advanced rectal cancer (LARC) has undergone a significant paradigm shift in recent years with the rising adoption of total neoadjuvant treatment (TNT). This comprehensive approach entails administering chemotherapy and radiation therapy before surgery, followed by optional adjuvant chemotherapy. To establish and deliver the optimal tailored treatment regimen to the patient, it is crucial to foster collaboration among a multidisciplinary team comprising healthcare professionals from various specialties, including medical oncology, radiation oncology, surgical oncology, radiology, and pathology. This review aims to provide insights into the current state of TNT for LARC and new emerging strategies to identify potential directions for future research and clinical practice, such as circulating tumor-DNA, immunotherapy in mismatch-repair-deficient tumors, and nonoperative management.
Keyphrases
- locally advanced
- rectal cancer
- radiation therapy
- circulating tumor
- neoadjuvant chemotherapy
- squamous cell carcinoma
- phase ii study
- palliative care
- healthcare
- clinical practice
- artificial intelligence
- cell free
- machine learning
- combination therapy
- climate change
- risk assessment
- circulating tumor cells
- replacement therapy
- clinical trial
- electronic health record
- deep learning
- patient reported outcomes
- study protocol
- human health
- radiation induced