Colon cancer - neoadjuvant treatment of non-metastatic disease

Neoadjuvant treatment for colon cancer, unlike rectal cancer, is rarely used. Its position in the treatment algorithm is not precisely defined. This treatment should be considered for locally significantly advanced tumors (cT4) with extensive nodal involvement. The neoadjuvant treatment plan should be determined in a multidisciplinary team setting. We describe the main clinical trials focused on neoadjuvant chemotherapy in colon cancer. A special subgroup is dMMR/MSI-high tumors, patients with such cancers are candidates for immunotherapy treatment. Immunotherapy can induce complete remission, but can also be accompanied by long-term or permanent toxicity of the treat-ment. Neoadjuvant immunotherapy of non-metastatic colon cancer is the subject of a number of clinical trials. Currently, no immunotherapy is registered in the EU for the neoadjuvant treatment of early colon cancer.