← Kelly Casteel, MD

The Organ-Preservation Era of Rectal Cancer

An interactive, clinician-facing chronicle of the trials that reshaped rectal cancer care — from total mesorectal excision and preoperative chemoradiation through total neoadjuvant therapy, watch-and-wait organ preservation, and the dMMR immunotherapy era that can erase surgery entirely, plus the biomarker-targeted agents for metastatic disease. Click any therapy to trace its trial lineage; click a trial for arms, endpoints, results, and FDA/EMA milestones.

Data verified against ClinicalTrials.gov & primary literature · last reviewed Jul 2026

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Drug class

Trial phase

Ph 1 Ph 2 Ph 3

Status

Approved Investigational Withdrawn / failed

Activity

Ongoing only

NCCN

In NCCN v2.2026 Category 1 only

Reference

Solid outline = approved Dashed outline = investigational Dashed rose = withdrawn / failed Pulsing dot = ongoing trial ✓badge = FDA / EMA approved NCCN category badge (1 / 2A / biomarker) Ambient curve = rising survival as approvals accrue

Scroll horizontally → · click a drug node to open its trial lineage

NCCN recommendations by clinical setting

Derived from NCCN Clinical Practice Guidelines in Oncology — Rectal Cancer

Preference tiers (Preferred / Other Recommended / Useful in certain circumstances) and Categories of Evidence (1, 2A, biomarker-restricted) are summarised for reference and attributed to NCCN. This is not a reproduction of the guideline; consult the authoritative, current version at nccn.org. Click a therapy chip to jump to that agent’s trial lineage. Biomarker-restricted options are noted inline.