Frontiers in Immunology (Dec 2022)
Neoadjuvant chemoradiotherapy combined with immunotherapy for locally advanced rectal cancer: A new era for anal preservation
- Yaqi Wang,
- Yaqi Wang,
- Yaqi Wang,
- Yaqi Wang,
- Lijun Shen,
- Lijun Shen,
- Lijun Shen,
- Lijun Shen,
- Juefeng Wan,
- Juefeng Wan,
- Juefeng Wan,
- Juefeng Wan,
- Hui Zhang,
- Hui Zhang,
- Hui Zhang,
- Hui Zhang,
- Ruiyan Wu,
- Ruiyan Wu,
- Ruiyan Wu,
- Ruiyan Wu,
- Jingwen Wang,
- Jingwen Wang,
- Jingwen Wang,
- Jingwen Wang,
- Yan Wang,
- Yan Wang,
- Yan Wang,
- Yan Wang,
- Ye Xu,
- Ye Xu,
- Sanjun Cai,
- Sanjun Cai,
- Zhen Zhang,
- Zhen Zhang,
- Zhen Zhang,
- Zhen Zhang,
- Fan Xia,
- Fan Xia,
- Fan Xia,
- Fan Xia
Affiliations
- Yaqi Wang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Yaqi Wang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Yaqi Wang
- Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Yaqi Wang
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
- Lijun Shen
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Lijun Shen
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Lijun Shen
- Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Lijun Shen
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
- Juefeng Wan
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Juefeng Wan
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Juefeng Wan
- Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Juefeng Wan
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
- Hui Zhang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Hui Zhang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Hui Zhang
- Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Hui Zhang
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
- Ruiyan Wu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Ruiyan Wu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Ruiyan Wu
- Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Ruiyan Wu
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
- Jingwen Wang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Jingwen Wang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Jingwen Wang
- Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Jingwen Wang
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
- Yan Wang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Yan Wang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Yan Wang
- Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Yan Wang
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
- Ye Xu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Ye Xu
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Sanjun Cai
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Sanjun Cai
- Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, China
- Zhen Zhang
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Zhen Zhang
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Zhen Zhang
- Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Zhen Zhang
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
- Fan Xia
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
- Fan Xia
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
- Fan Xia
- Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China
- Fan Xia
- Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
- DOI
- https://doi.org/10.3389/fimmu.2022.1067036
- Journal volume & issue
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Vol. 13
Abstract
For locally advanced (T3-4/N+M0) rectal cancer (LARC), neoadjuvant chemoradiotherapy (nCRT) followed by total mesorectal excision (TME) is the standard treatment. It was demonstrated to decrease the local recurrence rate and increase the tumor response grade. However, the distant metastasis remains an unresolved issue. And the demand for anus preservation and better quality of life increases in recent years. Radiotherapy and immunotherapy can be supplement to each other and the combination of the two treatments has a good theoretical basis. Recently, multiple clinical trials are ongoing in terms of the combination of nCRT and immunotherapy in LARC. It was reported that these trials achieved promising short-term efficacy in both MSI-H and MSS rectal cancers, which could further improve the rate of clinical complete response (cCR) and pathological complete response (pCR), so that increase the possibility of ‘Watch and Wait (W&W)’ approach. However, the cCR and pCR is not always consistent, which occurs more frequent when nCRT is combined with immunotherapy. Thus, the efficacy evaluation after neoadjuvant therapy is an important issue for patient selection of W&W approach. Evaluating the cCR accurately needs the combination of multiple traditional examinations, new detective methods, such as PET-CT, ctDNA-MRD and various omics studies. And finding accurate biomarkers can help guide the risk stratification and treatment decisions. And large-scale clinical trials need to be performed in the future to demonstrate the surprising efficacy and to explore the long-term prognosis.
Keywords
- locally advanced rectal cancer
- neoadjuvant chemoradiotherapy
- immunotherapy
- tumor response
- anus preservation
- research progress
