scholarly journals Systemic Treatment in Recurrent and Metastatic Unresectable Rectal Cancer

10.5772/27449 ◽  
2011 ◽  
Author(s):  
Francois-Xavier Otte ◽  
Mustapha Tehfe ◽  
Jean-Pierre Ayoub ◽  
Francine Aubi
Keyword(s):  
Rectal Cancer ◽  
Systemic Treatment

scholarly journals The value of oxaliplatin in the systemic treatment of locally advanced rectal cancer

2018 ◽  
Vol 9 (4) ◽  
pp. 631-640 ◽  
Author(s):  
Teresa Martín-Aragón ◽  
Javier Serrano ◽  
Juana Benedí ◽  
Rosa M. Meiriño ◽  
Pilar García-Alonso ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Systemic Treatment ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer

scholarly journals Neoadjuvant Immunotherapy–Based Systemic Treatment in MMR-Deficient or MSI-High Rectal Cancer: Case Series

2020 ◽  
Vol 18 (7) ◽  
pp. 798-804 ◽  
Author(s):  
Rahel Demisse ◽  
Neha Damle ◽  
Edward Kim ◽  
Jun Gong ◽  
Marwan Fakih ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Systemic Treatment ◽  
Treatment Options ◽  
Single Agent ◽  
Locally Advanced ◽  
Case Series ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Neoadjuvant Immunotherapy ◽  
History Of

Treatment options for locally advanced rectal cancer have continued to consist largely of chemotherapy, chemoradiation, and/or surgical resection. For patients who are unable to undergo these therapeutic modalities or who do not to experience a response to them, treatment options are limited. We report 3 cases of mismatch repair–deficient (dMMR) locally advanced adenocarcinoma of the rectum that showed significant response with neoadjuvant immunotherapy–based systemic treatment. The first patient was not eligible for standard therapy because of a history of radiotherapy to the prostate with concurrent comorbidities and therefore received single-agent pembrolizumab. The second patient did not respond to total neoadjuvant chemoradiation and subsequently received combined nivolumab and ipilimumab. The third patient had a known family history of Lynch syndrome and presented with locally advanced rectal cancer and a baseline carcinoembryonic antigen level of 1,566 ng/mL. She was treated using neoadjuvant pembrolizumab and FOLFOX (folinic acid, fluorouracil, oxaliplatin). In this small series, we suggest that single-agent and combined-modality neoadjuvant immunotherapy/chemotherapy appear to be safe and effective treatment options for patients with (dMMR) locally advanced rectal cancer. Our findings encourage further studies to investigate the role of neoadjuvant immunotherapy as a viable treatment strategy in this population.

Surgery, Radio- and Chemo- therapy for Multimodal Treatment of Rectal Cancer

Swiss Surgery ◽  
2001 ◽  
Vol 7 (6) ◽  
pp. 256-274 ◽  
Author(s):  
Link ◽  
Staib ◽  
Kornmann ◽  
Formentini ◽  
Schatz ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Multimodal Treatment ◽  
Local Relapse ◽  
Phase Iii ◽  
Neoadjuvant Radiotherapy ◽  
Term Survival ◽  
Primary Tumors ◽  
Impact On Survival ◽  
Relapse Rates

The possibilities and results of multimodal treatment in rectal cancer were reviewed with respect to the results of surgical treatment only. Based on the results of 4 studies, reducing local relapse rates and increasing long term survival rates significantly, postoperative radiochemotherapy (RCT) + chemotherapy (CT) should remain the recommended standard for R0 resected UICC II and III rectal cancers. The addition of RT to adjuvant CT reduces local relapses without significant impact on survival (NSABP R-02). Vice versa, the addition of CT to RT or an improved CT in the RCT-concept prolongs survival. Preoperative neoadjuvant radiotherapy (RT) reduced local relapse rates in 9 studies, and extended survival in one study that evaluated all eligible patients. Preoperative RT reduced local relapse rates in addition to total mesorectal excision (TME) but did not extend survival. The preoperative RCT + CT downstages resectable and nonresectable tumors and induces a higher sphincter preservation rate. Phase III data justifying its routine use in all UICC II + III stages are not yet available. This treatment may be routinely applied in nonresectable primary tumors or local relapses. Preoperative RCT (or RT) may evolve as standard, if the patient selection is improved and postoperative morbidity and long term toxicity reduced. Intraoperative RT could be added to this concept or be used together with preoperative/postoperative RT at the same indications. Postoperative adjuvant RT reduced local relapses significantly in a single trial, and no impact on survival time is reported. Since postoperative RT is inferior to preoperative RT, this treatment cannot be recommended, if RT is chosen as a single treatment modality in adjunction to surgery. The results of local tumor excisions may be improved with pre- or postoperative RCT + CT. In the future, multimodal treatment of rectal cancer might be more effective, if individualized according to prognostic factors.

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