title: Multidisciplinary management of locally advanced rectal cancer: neoadjuvant approaches.
abstract: Although tumor biology and genomics of colon and rectal cancer are no different, patients with locally advanced rectal cancer (LARC) require neoadjuvant fluoropyrimidine-based chemoradiation and total mesorectal excision. In addition to known clinical risk factors, improved algorithms integrating molecular tools are needed to stratify patients with LARC to improve treatment outcomes and reduce acute and long-term toxicities. Simply combining newer systemic or targeted agents with standard treatment in all patients yielded little success but added toxicities. This article reviews the historical data, current standards of care, and ongoing research efforts regarding biomarkers, molecular imaging, and personalized genomic information.
authors.affiliation: Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, Washington, USA
authors.forename: Swaminathan
authors.initials: S
authors.lastname: Murugappan
authors.forename: William P
authors.initials: WP
authors.lastname: Harris
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Willett
authors.forename: Edward
authors.initials: E
authors.lastname: Lin
mesh_terms: D003131:Combined Modality Therapy; D006801:Humans; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000473:pathology* / Q000628:therapy*