Biomaterial Database

Total neoadjuvant therapy for rectal cancer: An emerging option. 2017

Ethan B Ludmir, and Manisha Palta, and Christopher G Willett, and Brian G Czito

Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.

The treatment of locally advanced rectal cancer (LARC) has benefited from improved surgical techniques and from the implementation of neoadjuvant chemoradiotherapy (CRT), which have markedly decreased the rates of local recurrence. However, distant metastatic disease remains the most significant cause of death for these patients. Although adjuvant chemotherapy (ChT) after neoadjuvant CRT and definitive surgery is commonly recommended, the value of adjuvant systemic therapy remains less clear. Trials evaluating adjuvant ChT for rectal cancer have been handicapped by poor compliance rates and inconsistent survival results. Shifting systemic therapy delivery to the neoadjuvant setting has the promise to improve compliance rates, reduce toxicity, and decrease distant relapse rates. Recently, multiple prospective trials have reported on the use of total neoadjuvant therapy (TNT) for patients with LARC, incorporating both ChT and CRT in the neoadjuvant setting. Here, the authors review the promising results from those trials. Because the studies have largely focused on pathologic outcomes (primarily pathologic complete response rates), ongoing phase 2 and 3 trials are now underway assessing the long-term disease-related outcomes with TNT. In addition to improving survival, TNT has the potential to increase the pool of patients with LARC who are eligible for organ preservation, which is also being evaluated. Cancer 2017;123:1497-1506. © 2017 American Cancer Society.

UI	MeSH Term	Description	Entries
D012004	Rectal Neoplasms	Tumors or cancer of the RECTUM.	Cancer of Rectum,Rectal Cancer,Rectal Tumors,Cancer of the Rectum,Neoplasms, Rectal,Rectum Cancer,Rectum Neoplasms,Cancer, Rectal,Cancer, Rectum,Neoplasm, Rectal,Neoplasm, Rectum,Rectal Cancers,Rectal Neoplasm,Rectal Tumor,Rectum Cancers,Rectum Neoplasm,Tumor, Rectal
D012007	Rectum	The distal segment of the LARGE INTESTINE, between the SIGMOID COLON and the ANAL CANAL.	Rectums
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013505	Digestive System Surgical Procedures	Surgery performed on the digestive system or its parts.	Gastrointestinal Surgical Procedures,Digestive System Surgical Procedure,Gastrointestinal Surgical Procedure,Procedure, Digestive System Surgical,Procedure, Gastrointestinal Surgical,Procedures, Digestive System Surgical,Procedures, Gastrointestinal Surgical,Surgical Procedure, Digestive System,Surgical Procedure, Gastrointestinal,Surgical Procedures, Digestive System,Surgical Procedures, Gastrointestinal
D017024	Chemotherapy, Adjuvant	Drug therapy given to augment or stimulate some other form of treatment such as surgery or radiation therapy. Adjuvant chemotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment.	Adjuvant Chemotherapy,Drug Therapy, Adjuvant,Adjuvant Drug Therapy
D059248	Chemoradiotherapy	Treatment that combines chemotherapy with radiotherapy.	Concurrent Chemoradiotherapy,Concomitant Chemoradiotherapy,Concomitant Radiochemotherapy,Concurrent Radiochemotherapy,Radiochemotherapy,Synchronous Chemoradiotherapy,Chemoradiotherapies,Chemoradiotherapies, Concomitant,Chemoradiotherapies, Concurrent,Chemoradiotherapies, Synchronous,Chemoradiotherapy, Concomitant,Chemoradiotherapy, Concurrent,Chemoradiotherapy, Synchronous,Concomitant Chemoradiotherapies,Concomitant Radiochemotherapies,Concurrent Chemoradiotherapies,Concurrent Radiochemotherapies,Radiochemotherapies,Radiochemotherapies, Concomitant,Radiochemotherapies, Concurrent,Radiochemotherapy, Concomitant,Radiochemotherapy, Concurrent,Synchronous Chemoradiotherapies
D059351	Organ Sparing Treatments	Techniques, procedures, and therapies carried out on diseased organs in such a way to avoid complete removal of the organ and preserve the remaining organ function.	Organ Sparing Treatment,Sparing Treatment, Organ,Sparing Treatments, Organ,Treatment, Organ Sparing,Treatments, Organ Sparing
D020360	Neoadjuvant Therapy	Preliminary cancer therapy (chemotherapy, radiation therapy, hormone/endocrine therapy, IMMUNOTHERAPY, HYPERTHERMIA, INDUCED etc.) that is given before the main therapy.	Neoadjuvant Chemoradiation,Neoadjuvant Chemoradiation Therapy,Neoadjuvant Chemoradiation Treatment,Neoadjuvant Chemoradiotherapy,Neoadjuvant Chemotherapy,Neoadjuvant Chemotherapy Treatment,Neoadjuvant Radiation,Neoadjuvant Radiation Therapy,Neoadjuvant Radiation Treatment,Neoadjuvant Radiotherapy,Neoadjuvant Systemic Therapy,Neoadjuvant Systemic Treatment,Neoadjuvant Treatment,Chemoradiation Therapy, Neoadjuvant,Chemoradiation Treatment, Neoadjuvant,Chemoradiation, Neoadjuvant,Chemoradiotherapy, Neoadjuvant,Chemotherapy Treatment, Neoadjuvant,Chemotherapy, Neoadjuvant,Neoadjuvant Chemoradiation Therapies,Neoadjuvant Chemoradiation Treatments,Neoadjuvant Chemoradiations,Neoadjuvant Chemoradiotherapies,Neoadjuvant Chemotherapies,Neoadjuvant Chemotherapy Treatments,Neoadjuvant Radiation Therapies,Neoadjuvant Radiation Treatments,Neoadjuvant Radiations,Neoadjuvant Radiotherapies,Neoadjuvant Systemic Therapies,Neoadjuvant Systemic Treatments,Neoadjuvant Therapies,Neoadjuvant Treatments,Radiation Therapy, Neoadjuvant,Radiation Treatment, Neoadjuvant,Radiation, Neoadjuvant,Radiotherapy, Neoadjuvant,Systemic Therapy, Neoadjuvant,Systemic Treatment, Neoadjuvant,Therapy, Neoadjuvant,Therapy, Neoadjuvant Chemoradiation,Therapy, Neoadjuvant Radiation,Therapy, Neoadjuvant Systemic,Treatment, Neoadjuvant,Treatment, Neoadjuvant Chemoradiation,Treatment, Neoadjuvant Chemotherapy,Treatment, Neoadjuvant Radiation,Treatment, Neoadjuvant Systemic