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ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1513716
This article is part of the Research Topic The Application of Immune Checkpoint Inhibitors Combined with Chemotherapy in Tumor Immunotherapy View all 10 articles
Comparison of immunotherapy based total neoadjuvant therapy or standard neoadjuvant chemoradiation for locally advanced rectal cancer: a multi-institutional retrospective study
Provisionally accepted
Wen Zhao 1,2
Wenxing Gao 2 Jitao Du 3 Dingchang Li 2 Xianqiang Liu 2 Zhengyao Chang 4 Peng Chen 2 Xu Sun 1,2 Yingjie Zhao 5 Hanqing Jiao 6 Xiangbin Wan 3*
Dong Guanglong 1,2*- 1 School of Medicine, Nankai University, Tianjin, China
- 2 People's Liberation Army General Hospital, Beijing, China
- 3 the Affiliated Cancer Hospital of Zhengzhou University, Zheng Zhou, China
- 4 Fifth Medical Center of the PLA General Hospital, Beijing, Beijing Municipality, China
- 5 Eighth Medical Center of the General Hospital of the Chinese People's Liberation Army, Beijing, Beijing, China
- 6 Henan Provincial Cancer Hospital, Zhengzhou, Henan Province, China
Short running head: Rectal cancer total neoadjuvant therapy plus immunotherapy poorer DFS included age ≤50 years (P=0.044) and a neoadjuvant rectal (NAR) score ≥8 (P=0.008). Similarly, patients aged ≤50 years (P=0.025) exhibited a trend toward worse OS than those older than 50 years. The safety profiles of the two treatment groups were similar.Overall, ICIs + TNT demonstrated therapeutic efficacy and a safety profile comparable to ICIs + nCRT in patients with LARC and MSS/pMMR status.Although ICIs + TNT achieved numerically higher downstaging rates, it was not associated with improved survival outcomes. These findings underscore the importance of refining patient selection criteria and making judicious treatment decisions to enhance the prognosis of individuals with rectal cancer.
Keywords: Total neoadjuvant treatment, Locally advanced rectal cancer, Pathological complete response, downstaging, Survival
Received: 18 Oct 2024; Accepted: 20 Mar 2025.
Copyright: © 2025 Zhao, Gao, Du, Li, Liu, Chang, Chen, Sun, Zhao, Jiao, Wan and Guanglong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiangbin Wan, the Affiliated Cancer Hospital of Zhengzhou University, Zheng Zhou, China
Dong Guanglong, School of Medicine, Nankai University, Tianjin, 300192, China
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