Immunotherapy in High-Risk Rectal Cancer: Promising Results with Total Neoadjuvant Therapy

Researchers evaluated total neoadjuvant therapy with immunotherapy for high-risk rectal cancer with proficient mismatch repair status. The study showed a pathologic complete response rate of 33.3%, with 48% achieving clinical complete response. R0 resection was achieved in all patients. Adverse effects were manageable, with nausea being the most common. Patients with tumor shrinkage or clinical complete response had higher percentages of LRP1B mutation, associated with high tumor mutation burden and tumor neoantigen burden, which benefited from therapy.