Recent trends in locally advanced rectal cancer treatment have focused on risk-stratification of patients and tailoring treatment to achieve the best outcome while limiting the impact on long-term quality of life. There has been increasing interest in watch-and-wait approaches to achieve organ preservation. This article provides an overview of some major developments in the multimodal treatment of locally advanced rectal cancer, reviews controversial issues of the watch-and-wait approach and opportunities to personally tailor and reduce treatment, and provides an algorithm example of how such a personalized, tailored, adaptive, and reduced treatment could look like in the future.

This multicenter, open-label, randomized phase III trial conducted in Japan compared 3 versus 6 months of postoperative adjuvant chemotherapy in patients with curatively resected stage III colon cancer. Study participants received either a modified fluorouracil, leucovorin, and oxaliplatin, regimen, or capecitabine and oxaliplatin (CAPOX) regimen. Five-year OS rates were comparable between the two groups: 87.0% in the 3-month treatment group and 86.4% in the 6-month treatment group. Peripheral sensory neuropathy lasting longer than 5 years was twice as common in the 6- compared with 3-month treatment group (16% v 8%, respectively) and in those receiving mFOLFOX6 compared with CAPOX (14% v 11%, respectively).

In a small study of the PD-1 blocker dostarlimab, 100% of patients with locally advanced mismatch repair–deficient Stage II or III rectal adenocarcinoma experienced remission. The study participants were treated with dostarlimab monotherapy infused every three weeks for six months. The original intent was to follow dostarlimab with chemotherapy, radiation and surgery, but that turned out to be unnecessary.Read the study summary here.

Data for this study came from Danish medical registries over a 20-year period for 247,305 people who visited a hospital or were prescribed antiviral medication for herpes zoster and 1,235,890 people who did not have the disease. These individuals were an average age 64. Up to 21 years later, 9.7% of those with vs. 10.3% of those without herpes zoster developed dementia.

The findings were presented at the 2022 Annual Meeting of the American Academy of Sleep Medicine and the Sleep Research Society. The researchers gathered the data from eight different studies that explored the safety profile of ashwagandha — an herb also known as Indian Ginseng, winter cherry, or poison gooseberry — as well as the clinical significance of its beneficial effects.

The authors concluded that, after reviewing the 13-year-study, “switching to LAIs during the first 3 years of treatment improved antipsychotic adherence, decreased relapses, and reduced long-term mortality.” With few studies available comparing the long-term effectiveness between patients who switched to LAIs and those who remained on oral antipsychotics (OAPs), they hope the evidence presented supports the benefits of early LAI treatment in schizophrenia.