RAPIDO protocol: a promising approach for high-risk locally advanced rectal cancers

Neoadjuvant chemoradiation followed by surgery with or without adjuvant chemotherapy has remained the mainstay of treatment of locally advanced rectal cancers for the past two decades. Although this regimen has helped reduce rates of local recurrence to less than 5%, rates of systemic failure are still high (20–30%), leading to a 5-year overall survival of 75% at best. This situation has led to investigations into the use of total neoadjuvant therapy in the form of induction or consolidation chemotherapy, and a move towards treatment protocols focusing on organ preservation.