Immune checkpoint inhibition as a strategy in the neoadjuvant treatment of locally advanced rectal cancer

Hanna, Catherine R., O'Cathail, Séan M., Graham, Janet, Adams, Richard ORCID: https://orcid.org/0000-0003-3915-7243 and Roxburgh, Campbell S.D. 2021. Immune checkpoint inhibition as a strategy in the neoadjuvant treatment of locally advanced rectal cancer. Journal of Immunotherapy and Precision Oncology 4 (2) , pp. 86-104. 10.36401/JIPO-20-31

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Abstract

The treatment of locally advanced rectal cancer (LARC) has seen major advances over the past 3 decades, with multimodality treatment now standard of care. Combining surgical resection with radiotherapy and/or chemotherapy can reduce local recurrence from around 20% to approximately 5%. Despite improvements in local control, distant recurrence and subsequent survival rates have not changed. Immune checkpoint inhibitors have improved patient outcomes in several solid tumor types in the neoadjuvant, adjuvant, and advanced disease setting; however, in colorectal cancer, most clinical trials have been performed in the metastatic setting and the benefits confined to microsatellite instability–high tumors. In this article, we review the current preclinical and clinical evidence for using immune checkpoint inhibition in the treatment of LARC and discuss the rationale for specifically exploring the use of this therapy in the neoadjuvant setting. We summarize and discuss relevant clinical trials that are currently in setup and recruiting to test this treatment strategy and reflect on unanswered questions that still need to be addressed within future research efforts.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine Centre for Trials Research (CNTRR)
Additional Information:	This article is distributed under the terms of the latest Creative Commons Attribution-NonCommercial-NoDerivs (CC BY-NC-ND) License (https://creativecommons.org/licenses/by-nc-nd/4.0/) unless otherwise specified in writing.
ISSN:	2590-017X
Date of First Compliant Deposit:	21 February 2022
Date of Acceptance:	23 December 2020
Last Modified:	02 May 2023 11:38
URI:	https://orca.cardiff.ac.uk/id/eprint/147689

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