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Can We Predict Response and/or Resistance to Neoadjuvant Chemoradiotherapy in Patients with Rectal Cancer?

  • Localized Colorectal Cancer (R Glynne-Jones, Section Editor)
  • Published:
Current Colorectal Cancer Reports

Abstract

The current management of locally advanced rectal cancer consists of neoadjuvant chemoradiotherapy (CRT) followed by total mesorectal excision. Response to CRT varies significantly, and the ability to predict responsiveness, so that treatment modalities can be tailored to the tumor biology of the individual patient, remains a pressing goal. Although many studies have reported promising findings, no markers of response or resistance have been validated and widely incorporated into clinical use. However, many ongoing prospective clinical trials have the potential to dramatically change the standard of care for rectal cancer. This review summarizes the current understanding of predictors of response to CRT, ranging from patient-specific factors to radiologic modalities, with a special emphasis on the rapidly expanding field of molecular biomarkers derived from genomic data.

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Abbreviations

ADC:

Apparent diffusion coefficient

CRC:

Colorectal cancer

CRT:

Chemoradiotherapy

DCE:

Dynamic contrast-enhanced

FOLFOX:

5-Fluorouracil/leucovorin/oxaliplatin

5-FU:

5-Fluorouracil

LARC:

Locally advanced rectal cancer

MSI:

Microsatellite instability

pCR:

Pathologic complete response

TME:

Total mesorectal excision

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Acknowledgments

The authors thank Jenifer Levin, editor in the Colorectal Surgery Service at Memorial Sloan Kettering Cancer Center, for her assistance in editing this review. This work was supported by funding from NCI grants NCT00335816 and NCT00114231 (J.G.A).

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Conflict of Interest

Oliver S. Chow, J. Joshua Smith, Marc J. Gollub, and Julio Garcia-Aguilar declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Oliver S. Chow, J. Joshua Smith & Julio Garcia-Aguilar

  2. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Marc J. Gollub

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  1. Oliver S. Chow
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Correspondence to Julio Garcia-Aguilar.

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Chow, O.S., Smith, J.J., Gollub, M.J. et al. Can We Predict Response and/or Resistance to Neoadjuvant Chemoradiotherapy in Patients with Rectal Cancer?. Curr Colorectal Cancer Rep 10, 164–172 (2014). https://doi.org/10.1007/s11888-014-0210-0

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  • DOI: https://doi.org/10.1007/s11888-014-0210-0

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