Progress of immunotherapy combined with neoadjuvant radiotherapy in locally advanced rectal cancer
With the rapid development of immunotherapy,immune checkpoint inhibitors(ICIs)have been adminis-trated widely in locally advanced rectal cancer(LARC).Compared to single use of neoadjuvant radiotherapy or immuno-therapy,the combination of neoadjuvant radiotherapy and immunotherapy shows better clinical and pathological complete response rates.There is still no consensus on key technical issues such as.In this review,we summarized representative results from published trials and the latest clinical trial registered on clinicaltrials.gov.The intervention of neoadjuvant ra-diotherapy combined with immunotherapy in LARC is recorded in detail,including the specific dose and fractionation of neoadjuvant radiotherapy,the duration and cycles of immunotherapy,the sequence of combined neoadjuvant radio-immu-notherapy,the interval between the end of neoadjuvant therapy and total mesorectal excision(TME)surgery,and the use of postoperative adjuvant therapy.We also concluded the progress of researches on underlying mechanisms of radiotherapy-induced sensitization in tumor immune microenvironment in ways of immunoinfiltration,abscopal effect,and gut microbio-ta.At the same time,the research progress of predictive biomarkers for immunotherapy efficacy in LARC is reviewed.It was hoped that this paper will provide reference and guidance for the selection of clinical treatment for LARC and the de-sign of future clinical studies.
rectal cancerlocally advanced rectal cancerneoadjuvant radiotherapyimmunotherapyneoadju-vant radiotherapy combined with immunotherapy
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