Can We Predict Response and/or Resistance to Neoadjuvant Chemoradiotherapy in Patients with Rectal Cancer?

Abstract

The current management of locally advanced rectal cancer consists of neoadjuvant chemoradiotherapy (CRT) followed by total mesorectal excision. Response to CRT varies significantly, and the ability to predict responsiveness, so that treatment modalities can be tailored to the tumor biology of the individual patient, remains a pressing goal. Although many studies have reported promising findings, no markers of response or resistance have been validated and widely incorporated into clinical use. However, many ongoing prospective clinical trials have the potential to dramatically change the standard of care for rectal cancer. This review summarizes the current understanding of predictors of response to CRT, ranging from patient-specific factors to radiologic modalities, with a special emphasis on the rapidly expanding field of molecular biomarkers derived from genomic data.