Rectal cancer is treated with surgery, radiation, and chemotherapy, often in combination. In recent years, some patients with early-stage disease have avoided surgery entirely through radiation or chemotherapy that eliminates visible tumor. Research now focuses on immune therapy, targeted drugs, and ways to preserve organ function without compromising cure rates.
What's actually going on in research
Trials are testing immune checkpoint inhibitors in tumors with mismatch repair deficiency, targeted drugs against specific mutations like KRAS G12C, and total neoadjuvant therapy that delivers all treatment before surgery. Researchers are studying whether patients whose tumors disappear after treatment can safely skip surgery, and whether short-course radiation or chemotherapy alone can achieve the same results.
Immune checkpoint inhibitors
Drugs like pembrolizumab and dostarlimumab show high response rates in rectal cancers with mismatch repair deficiency, sometimes eliminating tumors without surgery or radiation. Studies are exploring their use earlier in treatment and in more patients.
Watch-and-wait approach
Trials are defining which patients whose tumors disappear after chemoradiation can safely avoid surgery. This approach preserves bowel function and quality of life while maintaining cure rates in selected patients.
Total neoadjuvant therapy
Delivering all chemotherapy and radiation before surgery appears to shrink tumors more effectively and may allow more patients to avoid permanent colostomy. Multiple trials are refining the best sequence and combinations.
What to know before you search
Eligibility typically depends on tumor stage, distance from the anal sphincter, genetic markers like mismatch repair status, and response to any prior treatment.
What types of trials are currently open
- Neoadjuvant treatment trials — Testing combinations of chemotherapy, radiation, and targeted drugs given before surgery to shrink tumors and potentially avoid surgery altogether.
- Immunotherapy trials — Testing checkpoint inhibitors in rectal cancers with specific biomarkers, often aiming to eliminate tumors without surgery or radiation.
- Targeted therapy trials — Testing drugs that target specific mutations like KRAS, BRAF, or HER2 in combination with chemotherapy or immunotherapy.
- Organ preservation trials — Studies comparing watch-and-wait to immediate surgery in patients whose tumors respond completely to initial treatment.
- Quality of life studies — Following patients to understand long-term bowel, sexual, and urinary function after different treatment approaches.
Recently added Rectal Cancer trials
Efficacy and Safety of Transcutaneous Posterior Tibial Nerve Stimulation on Fecal Continence in Patients Undergoing Surgery for Rectal Neoplasia
Rectal neoplasia is one of the most prevalent cancers in Spain, and the treatment of choice is total mesorectal excision (TME), as it has demonstrated significant oncological improvements. However, mesorectal excision is not without complications, and patients often experience altered bowel function in the form of low anterior resection syndrome (LARS), as well as erectile dysfunction. However, few studies evaluate faecal incontinence, as most focus on oncological outcomes. The aim of our study is to evaluate the efficacy and safety of posterior tibial nerve stimulation on fecal incontinence, sexual dysfunction, and quality of life in patients who underwent to rectal surgery for rectal neoplasia. It will be conducted a randomized clinical trial (1:1) with two arms: half of the patients will receive posterior tibial nerve stimulation, while the other half will undergo stimulation with subtherapeutic doses. Faecal incontinence will be assessed using the LARS and Wexner questionnaires, and quality of life and sexual function will be assessed using the Fecal Incontinence Quality of Life Scale (FIQLS) and the Colorectal Cancer Quality of Life Questionnaire (QLQ-CR38), at one month, six months and one year after surgery.
Impact of SMS Messaging on Participation in Colorectal Cancer Screening.
Colorectal cancer is a leading cause of mortality in Catalonia. Although early detection programs using the fecal immunochemical test (FIT) are effective in reducing both incidence and mortality, their success relies on high population participation. Currently, in the Vallès Occidental region, the participation rate stands at 42%, which is below the 65% minimum recommended by European health authorities. The objective of this randomized controlled trial is to evaluate whether sending a reminder text message (SMS) is an effective tool to increase participation in the screening program. The study will include 10,084 participants aged between 50 and 69 years. Half of the participants will receive a reminder SMS five weeks after their initial invitation, while the other half will follow the standard of care involving postal letters. Researchers anticipate that this strategy will not only increase the number of individuals undergoing screening but also shorten the response time and reduce the need for sending postal reminders.
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