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*Author for correspondence:

Department of Radiation Oncology, University Hospital Virgen del Rocío, Biomedical Institute of Seville (IBIS)/CSIC/University of Seville, Seville, 41013, Spain

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Daniela Gonsalves Pieretti

Department of Radiation Oncology, Genesiscare, Madrid, 28002, Spain

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Paula Peleteiro Higuero

Department of Radiation Oncology, University Hospital Santiago de Compostela, 15706, Santiago de Compostela, Spain

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Elisabet González Del Portillo

Department of Radiation Oncology, University Hospital La Paz, Madrid, 28046, Spain

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Virginia Morillo Macías

Department of Radiation Oncology, Castellón Provincial Hospital, Castellón, 12002, Spain

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María Mateos Domínguez

Department of Radiation Oncology, Genesiscare, Madrid, 28002, Spain

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Raquel Fuentes Mateos

Department of Medical Oncology, University Hospital Ramón y Cajal, Madrid, 28034, Spain

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Fernando Lopez Campos

Radiation Oncology Department, University Hospital Ramon y Cajal, Madrid, 28034, Spain

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Ana Aurora Díaz-Gavela

Quironsalud Madrid University Hospital, Radiation Therapy Department, Medicine Department, School of Biomedical Sciences, Universidad Europea, Madrid, 28223, Spain

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Gustavo Ferraris

Radiotherapy Unit, Centro de Radioterapia Dean Funes, Córdoba, X5003 CVY, Argentina

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Felipe Couñago

San Francisco de Asís and La Milagrosa Hospitals, GenesisCare, Madrid, 28002, Spain

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Published Online:31 Aug 2023https://doi.org/10.2217/fon-2023-0481

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Abstract

Locally advanced rectal cancer has traditionally been treated with chemoradiotherapy (CRT) followed by surgery and adjuvant chemotherapy. However, a new strategy, total neoadjuvant therapy, involves the administration of CRT and neoadjuvant chemotherapy with the aim of eradicating micrometastases earlier and achieving greater control of the disease. The use of total neoadjuvant therapy has shown higher rates of pathological complete response and resectability compared with CRT, including improved survival. Nevertheless, distant relapse is the main cause of morbidity and mortality in locally advanced rectal cancer. To address this, new biomarkers are being developed to predict disease response.

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Exciting breakthrough and results in rectal cancer treatment with total neoadjuvant therapy. Chemoradiotherapy and presurgery chemotherapy for better disease control. Higher complete response rates and improved survival. Ongoing search for new biomarkers. #FutureOncology

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Papers of special note have been highlighted as: • of interest; •• of considerable interest

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Vol. 19, No. 25

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History

Received 28 May 2023

Accepted 18 July 2023

Published online 31 August 2023

Published in print August 2023

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Keywords

Author contributions

Article writing and table preparation: E Gomis Sellés, D Gonsalves Pieretti, P Peleteiro Higuero, E González Del Portillo, V Morillo Macías, M Mateos Domínguez, R Fuentes Mateos. Review of the article and pertinent modifications: all authors.

Financial & competing interests disclosure

F Couñago declares sponsored research: Janssen; consulting, advisory role: Janssen, AstraZeneca; lectures and educational activities: Janssen, Roche Farma, AstraZeneca, Astellas; travel, accommodations, expenses: AstraZeneca, Astellas, Janssen, Roche Farma. F Lopez Campos declares consulting, advisory role: Janssen, AstraZeneca, Bayer, Astellas, Casen Recordati; lectures and educational activities: Janssen, AstraZeneca, Bayer, Astellas, Casen Recordati; travel accommodations, expenses: Janssen, AstraZeneca, Bayer, Astellas, Casen Recordati. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

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Total neoadjuvant therapy for locally advanced rectal cancer: a narrative review

Abstract

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References