Changing patterns of neoadjuvant therapy for locally advanced rectal cancer: A narrative review

He, Weijing; Li, Qingguo; Li, Xinxiang

doi:10.1016/j.critrevonc.2022.103885

Cited by 5 publications

(1 citation statement)

References 105 publications

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“…In recent years, NT has been widely adopted due to its capability in advancing the effectiveness of clinical cancer treatment, as well as improving the prognosis of cancer patients ( 29 , 31 , 32 ). However, there is still controversy over the options and models of NT for ESCA.…”

Section: Discussionmentioning

confidence: 99%

Neoadjuvant immunochemotherapy improves clinical outcomes of patients with esophageal cancer by mediating anti-tumor immunity of CD8+ T (Tc1) and CD16+ NK cells

He,

Yang,

Lin

et al. 2024

Front. Immunol.

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BackgroundEsophageal cancer (ESCA) is one of the most common tumors in the world, and treatment using neoadjuvant therapy (NT) based on radiotherapy and/or chemotherapy has still unsatisfactory results. Neoadjuvant immunochemotherapy (NICT) has also become an effective treatment strategy nowadays. However, its impact on the tumor microenvironment (TME) and regulatory mechanisms on T cells and NK cells needs to be further elucidated.MethodsA total of 279 cases of ESCA who underwent surgery alone [non-neoadjuvant therapy (NONE)], neoadjuvant chemotherapy (NCT), and NICT were collected, and their therapeutic effect and survival period were compared. Further, RNA sequencing combined with biological information was used to analyze the expression of immune-related genes. Immunohistochemistry, immunofluorescence, and quantitative real-time PCR (qRT-PCR) were used to verify the activation and infiltration status of CD8+ T and CD16+ NK cells, as well as the function and regulatory pathway of killing tumor cells.ResultsPatients with ESCA in the NICT group showed better clinical response, median survival, and 2-year survival rates (p < 0.05) compared with the NCT group. Our RNA sequencing data revealed that NICT could promote the expression of immune-related genes. The infiltration and activation of immune cells centered with CD8+ T cells were significantly enhanced. CD8+ T cells activated by PD-1 inhibitors secreted more IFN-γ and cytotoxic effector factor cells through the transcription factor of EOMES and TBX21. At the same time, activated CD8+ T cells mediated the CD16+ NK cell activation and secreted more IFN-γ to kill ESCA cells. In addition, the immunofluorescence co-staining results showed that more CD276+ tumor cells and CD16+ NK cells were existed in pre-NCT and pre-NICT group. However, CD276+ tumor cells were reduced significantly in the post-NICT group, while they still appeared in the post-NCT group, which means that CD16+ NK cells can recognize and kill CD276+ tumor cells after immune checkpoint blocker (ICB) treatment.ConclusionNICT can improve the therapeutic effect and survival period of resectable ESCA patients. NICT could promote the expression of immune-related genes and activate CD8+ T and CD16+ NK cells to secrete more IFN-γ to kill ESCA cells. It provides a theoretical basis and clinical evidence for its potential as an NT strategy in ESCA.

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Section: Discussionmentioning

confidence: 99%

Neoadjuvant immunochemotherapy improves clinical outcomes of patients with esophageal cancer by mediating anti-tumor immunity of CD8+ T (Tc1) and CD16+ NK cells

He,

Yang,

Lin

et al. 2024

Front. Immunol.

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Developing Individualized Follow‐Up Strategies Based on High‐Risk Recurrence Factors and Dynamic Risk Assessment for Locally Advanced Rectal Cancer

Qiu,

Yu,

Wang

et al. 2024

Cancer Medicine

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BackgroundLocally advanced rectal cancer (LARC) is one of the most common malignant tumors worldwide, and its incidence is increasing year by year. Despite multimodal treatment, the recurrence rate of LARC patients remains high, about 20%–50%. However, the follow‐up strategy according to tumor stage has certain limitations. There is no consensus on the optimal frequency and duration of follow‐up. This study aims to comprehensively analyze the high‐risk factors for recurrence in LARC from clinical characteristics, nutritional indicators, and imaging indexes. It intends to utilize conditional survival (CS) evaluation to assess dynamic survival and recurrence risks after comprehensive treatment of LARC and to develop individualized follow‐up strategies.MethodsLogistic regression was utilized to analyze the independent recurrence factors in LARC patients. Calibration curve, decision curve, and ROC curve were employed to evaluate the model's efficacy. Kaplan–Meier curve was used to calculate CS rate and compare survival differences among different risk groups.ResultsA total of 561 patients were analyzed in our study. Our multivariable logistic regression analysis revealed that the prognostic nutritional index (PNI), extramural vascular invasion (EMVI), vascular tumor thrombus, perineural invasion, and tumor size were independent factors for recurrence. Subsequently, a nomogram model was constructed and risk stratification was performed. Calibration curves and decision curves demonstrated that the model exhibited good clinical efficacy. The area under the ROC curve for the model was 0.763, indicating good sensitivity and specificity. Kaplan–Meier curves showed significant differences in survival among different risk groups. Furthermore, we observed that the CS without local recurrence and distant metastasis increased each year, while the cumulative recurrence risk decreased annually with prolonged survival time. Tailored follow‐up intensities were developed for different risk groups and clinical stages based on the cumulative recurrence risk.ConclusionThe personalized follow‐up strategy based on risk stratification can optimize resource allocation, early detection of recurrence or metastasis, and ultimately enhance the overall care and prognosis of LARC patients.

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Is neoadjuvant folfox an effective treatment only in a very selected favorable subgroup of locally advanced rectal cancer?

Riou,

Castan,

Conroy

2024

Cancer/Radiothérapie

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Changing patterns of neoadjuvant therapy for locally advanced rectal cancer: A narrative review

Cited by 5 publications

References 105 publications

Neoadjuvant immunochemotherapy improves clinical outcomes of patients with esophageal cancer by mediating anti-tumor immunity of CD8+ T (Tc1) and CD16+ NK cells

Neoadjuvant immunochemotherapy improves clinical outcomes of patients with esophageal cancer by mediating anti-tumor immunity of CD8+ T (Tc1) and CD16+ NK cells

Developing Individualized Follow‐Up Strategies Based on High‐Risk Recurrence Factors and Dynamic Risk Assessment for Locally Advanced Rectal Cancer

Is neoadjuvant folfox an effective treatment only in a very selected favorable subgroup of locally advanced rectal cancer?

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