Total Neoadjuvant Therapy for High Risk Rectal Cancer in Western and Asian Populations - Current Evidence and...

Area of Science:

• Oncology
• Surgical Oncology
• Gastrointestinal Oncology

Background:

• Total Neoadjuvant Therapy (TNT) involves chemotherapy before or after neoadjuvant radiotherapy (RT) for high-risk rectal cancer.
• Randomized controlled trials (RCTs) indicate TNT improves disease-free survival (DFS) and pathologic complete response (pCR).

Purpose of the Study:

• To review key RCT results on TNT approaches in Western and East Asian populations.
• To discuss the impact of TNT on clinical practice, research, and identify areas of controversy.

Main Methods:

• Review of recent randomized controlled trials (RCTs) on Total Neoadjuvant Therapy (TNT).
• Analysis of data from Western and East Asian populations regarding TNT efficacy and implementation.

Main Results:

• TNT demonstrates improved DFS, pCR rates, and treatment compliance in high-risk rectal cancer.
• Significant variations exist in TNT adoption and guidelines between Western and East Asian regions.

Conclusions:

• TNT is a promising strategy for high-risk rectal cancer, but optimal duration and patient selection require further study.
• Ongoing RCTs and biomarker research are crucial for refining risk-adapted TNT implementation and personalized treatment.