Despite therapeutic advancements, disease-free survival and overall survival have not improved in patients with locally advanced rectal cancer due to distant metastases. Total neoadjuvant therapy (TNT) is now standard to prevent local recurrence and distant metastases. Patients with high-risk features may benefit, but non-responsive patients have poor prognosis. Integrated multi-omics analysis and AI may predict treatment response, guiding non-operative management decisions. Collaborative trials are working to better understand TNT response drivers for future optimization.
Review by Kagawa Y, Smith JJ (…) Yoshino T et 14 al. in Nat Rev Gastroenterol Hepatol
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