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<p>Standard neoadjuvant chemoradiotherapy for locally advanced rectal cancer (LARC) is associated with significant toxicity and limited pathological responses. We retrospectively compared a radiotherapy‑free regimen of camrelizumab plus modified FOLFOXIRI versus modified FOLFOXIRI alone in consecutive patients with clinical stage II–III LARC treated from 2022–2025 (<i>n</i> = 146). All patients received ≥3 cycles of neoadjuvant therapy; surgery or watch‑and‑wait was determined by a multidisciplinary team. Baseline characteristics were well balanced. Among surgical patients, pCR rates were 29.8% with camrelizumab plus FOLFOXIRI and 19.6% with FOLFOXIRI alone. Radiologic objective response rates were 70.7% and 53.5%, respectively, and mean neoadjuvant rectal scores were lower with camrelizumab (13.95 vs 23.77; <i>P</i> &lt; 0.02). Disease‑free survival was significantly improved in the camrelizumab group, while overall survival was similar at current follow‑up. Grade 3–4 hematologic and gastrointestinal toxicities were comparable, and no unexpected immune‑related events occurred. Camrelizumab plus FOLFOXIRI appears to be an active, tolerable radiotherapy‑free neoadjuvant option for LARC.</p>

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Neoadjuvant FOLFOXIRI chemotherapy with or without camrelizumab in the treatment of locally advanced rectal cancer: a retrospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月4日

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  • Yanlong Liu,
  • Shihui Zhao,
  • Fenqi Du,
  • Songtao Du,
  • Liqiang Song,
  • Tianyi Xia,
  • Bomiao Zhang,
  • Binbin Cui

摘要

Standard neoadjuvant chemoradiotherapy for locally advanced rectal cancer (LARC) is associated with significant toxicity and limited pathological responses. We retrospectively compared a radiotherapy‑free regimen of camrelizumab plus modified FOLFOXIRI versus modified FOLFOXIRI alone in consecutive patients with clinical stage II–III LARC treated from 2022–2025 (n = 146). All patients received ≥3 cycles of neoadjuvant therapy; surgery or watch‑and‑wait was determined by a multidisciplinary team. Baseline characteristics were well balanced. Among surgical patients, pCR rates were 29.8% with camrelizumab plus FOLFOXIRI and 19.6% with FOLFOXIRI alone. Radiologic objective response rates were 70.7% and 53.5%, respectively, and mean neoadjuvant rectal scores were lower with camrelizumab (13.95 vs 23.77; P < 0.02). Disease‑free survival was significantly improved in the camrelizumab group, while overall survival was similar at current follow‑up. Grade 3–4 hematologic and gastrointestinal toxicities were comparable, and no unexpected immune‑related events occurred. Camrelizumab plus FOLFOXIRI appears to be an active, tolerable radiotherapy‑free neoadjuvant option for LARC.