J Cancer 2021; 12(2):417-427. doi:10.7150/jca.48337

Review

Adding Adjuvants to Fluoropyrimidine-based Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer: An Option Worthy of Serious Consideration

Fengpeng Wu1#, Chaoxi Zhou2#, Bingyuan Wu3, Xiaoxiao Zhang1, Kanghua Wang1, Jun Wang1, Linlin Xiao1, Guiying Wang2✉

1. Department of Radiation Oncology, Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
2. Department of Colorectal Surgery, Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
3. Department of Medical Imaging, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
#Co-first authors with equal contributions to this work.

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Citation:
Wu F, Zhou C, Wu B, Zhang X, Wang K, Wang J, Xiao L, Wang G. Adding Adjuvants to Fluoropyrimidine-based Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer: An Option Worthy of Serious Consideration. J Cancer 2021; 12(2):417-427. doi:10.7150/jca.48337. Available from https://www.jcancer.org/v12p0417.htm

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Abstract

The application of fluoropyrimidine-based neoadjuvant chemoradiotherapy (Fu-nCRT) of locally advanced rectal cancer (LARC) has become a common therapeutic regimen. In order to improve the efficacy and enable more patients to benefit from this treatment, an accumulation of studies have been carried out on the auxiliary use of other drugs with Fu-nCRT. However, due to specific challenges and the potential opportunities that coexist in this field, a more reasonable approach to the mode of treatment remains to be explored. In this review, we have summarized the results of the studies on the combination of Fu-nCRT with cytotoxic drugs, anti-tumor angiogenesis, and anti-EGFR agents, as well as the status of the application of immune checkpoint inhibitors in the neoadjuvant therapy of LARC patients.

Keywords: locally advanced rectal cancer, neoadjuvant chemoradiotherapy, adjuvants, cytotoxic chemotherapeutic drugs, molecular targeted anticancer drugs, immune checkpoint inhibitors