Role of Radiotherapy in Rectal Cancer Dominik Modest, MD · Charité – Universitätsmedizin Berlin ++++

https://decisionpoint.medscape.com/oncology/viewarticle/944865?src=0_nl_sm_0&uac=148436CN Key Takeaways: Patients with rectal cancer who are considered for interdisciplinary treatment are typically those with low or middle third tumors. Such tumors are usually up to 12 cm from the anocutaneous line. These rectal cancers have a T3 or T4 magnetic resonance imaging (MRI)-staged tumor and/or nodal positivity. Patients with rectal cancer have historically been treated with radiochemotherapy, followed by surgery and possible adjuvant chemotherapy for an extended period of time. Current treatment strategies, such as those described in the RAPIDO and PRODIGE 23 clinical trials, will most likely include radiotherapy for those individuals at high risk, supplemented with the use of additional systemic therapy. Currently, it is being suggested that patients with low-risk T3 rectal tumors with a small margin and without any metastases in the lymph nodes be treated with surgery and/or chemotherapy in the future, without the need for radiotherapy—that is, the de-escalation of radiotherapy in low-risk advanced rectal cancers. Neoadjuvant Chemotherapy in Colon Cancer: Who Is the Ideal Candidate? Chiara Cremolini, MD, PhD · University of Pisa https://decisionpoint.medscape.com/oncology/viewarticle/944624?src=0_nl_sm_0&uac=148436CN Key Takeaways: The concept of using neoadjuvant chemotherapy is beginning to be considered in colon cancer Neoadjuvant chemotherapy has the potential to shrink micrometastases sufficiently to provide early control of micrometastatic disease through radical surgical intervention The FOxTROT trial revealed some promising data for the use of neoadjuvant chemotherapy in colon cancer, although questions remain about adequate staging of the disease to prevent overtreatment RET Fusions in CRC John L. Marshall, MD · Georgetown University https://decisionpoint.medscape.com/oncology/viewarticle/984929?src=0_nl_sm_0&uac=148436CN Key Takeaways: In mCRC, MSI, RAS, BRAF, and HER2 mutations are generally tested for prior to treatment, and to guide additional therapies; however, RET fusions may also be useful in determining treatment regimens. RET fusions, which involve a chromosome portion fused to another chromosome, can lead to an overproduction signal on a tyrosine kinase gene. RET fusions are thought to be present in only 2% of mCRC patients, however, a recent study suggested selpercatinib led to a 45% response rate in any cancer. Adjuvant Therapy for Small Bowel Adenocarcinoma Katrina S. Pedersen, MS, MD · Washington University https://decisionpoint.medscape.com/oncology/viewarticle/921576?src=0_nl_sm_0&uac=148436CN