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Targeted Cancer Therapies02:57

Targeted Cancer Therapies

The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...

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Stereotactic Radiosurgery for Gynecologic Cancer
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Response-guided Strategy Based on Induction Chemotherapy Without Routine Use of Radiotherapy for Locally Advanced

Atsushi Ogura1, Yuki Murata2, Masanori Sando3

  • 1Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan; ogura.atsushi.r2@f.mail.nagoya-u.ac.jp.

Anticancer Research
|August 1, 2025
PubMed
Summary

Induction chemotherapy helps select rectal cancer patients for nonoperative management (NOM), potentially avoiding radiotherapy. This personalized approach aims to improve outcomes and quality of life by reducing surgery.

Keywords:
Locally advanced rectal cancerinduction chemotherapynonoperative managementtotal neoadjuvant therapy

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Area of Science:

  • Oncology
  • Rectal Cancer Treatment
  • Neoadjuvant Therapy

Background:

  • Total neoadjuvant therapy (TNT) shows promise for locally advanced rectal cancer (LARC) in reducing metastasis and enabling nonoperative management (NOM).
  • Concerns persist regarding total mesorectal excision (TME) quality and local regrowth post-NOM.
  • A response-guided strategy using induction chemotherapy was investigated to improve patient selection and outcomes.

Purpose of the Study:

  • To evaluate a response-guided strategy centered on induction chemotherapy for locally advanced rectal cancer.
  • To assess the feasibility of enhancing patient selection for nonoperative management (NOM).
  • To explore the potential for omitting routine radiotherapy in select LARC cases.

Main Methods:

  • Patients with clinical Stage II/III lower rectal cancer received three months of induction chemotherapy (oxaliplatin-based doublet or triplet).
  • Long-course chemoradiotherapy was selectively administered based on multidisciplinary team evaluation.
  • Treatment aimed at facilitating NOM or minimizing local recurrence in mesorectal fascia (MRF)-involved cases.

Main Results:

  • Thirty-nine percent of patients achieved a complete or near-complete response after initial restaging.
  • Five patients proceeded to NOM post-chemoradiotherapy, achieving 100% TME-free survival.
  • R0 resections were achieved in all 13 surgical cases; some patients omitted chemoradiotherapy based on response.

Conclusions:

  • Induction chemotherapy effectively identifies suitable candidates for NOM in LARC.
  • This strategy may allow for the omission of routine radiotherapy, personalizing treatment.
  • The approach aims to improve quality of life by reducing surgery and preserving rectal function.