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Narrative Review : Predictive Biomarkers of Tumor Response to Neoadjuvant Radiotherapy or Total Neoadjuvant Therapy of Locally Advanced Rectal Cancer Patients

Title: Narrative Review : Predictive Biomarkers of Tumor Response to Neoadjuvant Radiotherapy or Total Neoadjuvant Therapy of Locally Advanced Rectal Cancer Patients
Authors: Machado Carvalho, Joao Victor; Meyer, Jeremy; Ris, Frédéric; Durham, André; Bornand, Aurélie; Ricoeur, Alexis; Corro, Claudia; Kossler, Thibaud
Source: ISSN: 2072-6694 ; Cancers, vol. 17, no. 13 (2025) 2229.
Publication Year: 2025
Collection: Université de Genève: Archive ouverte UNIGE
Subject Terms: info:eu-repo/classification/ddc/616.0757; info:eu-repo/classification/ddc/616.07; info:eu-repo/classification/ddc/616; info:eu-repo/classification/ddc/617; TRG; Biomarker; PCR; Radiotherapy; Rectal cancer; Short-course radiotherapy; Total neoadjuvant treatment; Tumor response
Description: Background/Objectives: Treatment of locally advanced rectal cancer (LARC) very often requires a neoadjuvant multimodal approach. Neoadjuvant treatment (NAT) encompasses treatments like chemoradiotherapy (CRT), short-course radiotherapy (SCRT), radiotherapy (RT) or a combination of either of these two with additional induction or consolidation chemotherapy, namely total neoadjuvant treatment (TNT). In case of complete radiological and clinical response, the non-operative watch-and-wait strategy can be adopted in selected patients. This strategy is impacted by a regrowth rate of approximately 30%. Predicting biomarkers of tumor response to NAT could improve guidance of clinicians during clinical decision making, improving treatment outcomes and decreasing unnecessary treatment exposure. To this day, there is no validated biomarker to predict tumor response to any NAT strategies in clinical use. Most research focused on CRT neglects the study of other regimens. Methods : We conducted a narrative literature review which aimed at summarizing the status of biomarkers predicting tumor response to NAT other than CRT in LARC. Results : Two hundred and fourteen articles were identified. After screening, twenty-one full-text articles were included. Statistically significant markers associated with improved tumor response pre-treatment were as follows: low circulating CEA levels; BCL-2 expression; high cellular expression of Ku70, MIB-1(Ki-67) and EGFR; low cellular expression of VEGF, hPEBP4 and nuclear β-catenin; the absence of TP53, SMAD4, KRAS and LRP1B mutations; the presence of the G-allel of LCS-6; and MRI features such as the conventional biexponential fitting pseudodiffusion (Dp) mean value and standard deviation (SD), the variable projection Dp mean value and lymph node characteristics (short axis, smooth contour, homogeneity and Zhang et al. radiomic score). In the interval post-treatment and before surgery, significant markers were as follows: a reduction in the median value of circulating free DNA, higher ...
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/40647527; unige:186716
Availability: https://archive-ouverte.unige.ch/unige:186716
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.2A0CB375
Database: BASE