ArticleFrontiers in immunology2026
Watch-and-wait after immunotherapy-containing neoadjuvant treatment in pMMR/MSS locally advanced rectal cancer: a multicenter real-world study.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Watch-and-wait (W&W) is an organ-preserving option for rectal cancer patients who achieve clinical complete response (cCR), but post-cCR outcomes after immunotherapy-containing neoadjuvant treatment in proficient mismatch repair (pMMR)/microsatellite stable (MSS) locally advanced rectal cancer (LARC) remain unclear. We evaluated post-cCR oncological and organ-preservation outcomes in this selected population. Methods: This multicenter retrospective cohort study included patients with pMMR/MSS LARC who achieved cCR after immunotherapy-containing neoadjuvant treatment at three medical centers and subsequently underwent W&W. Eligible patients had at least 12 months of post-cCR follow-up. Disease progression, survival, and organ-preservation outcomes were evaluated, and survival was estimated using the Kaplan-Meier method. Results: Twenty-five patients were included, with a median post-cCR follow-up of 26 months (range, 14-40 months). Three patients (12.0%) developed disease progression, including two with local regrowth and one with lung metastasis. Both local regrowths were treated with R0 salvage surgery. The estimated 2-year disease-free survival was 87.4% (95% CI, 65.7%-95.8%). Twenty-three patients (92.0%) avoided radical surgery, and 22 patients (88.0%) maintained disease-free organ preservation. Conclusion: This multicenter study provides preliminary real-world evidence on W&W after cCR in highly selected patients with pMMR/MSS LARC treated with immunotherapy-containing neoadjuvant regimens, but larger prospective comparative studies with longer follow-up are required before its feasibility and oncological safety can be established.
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