Treatment De-Escalation Strategies for Locally Advanced Rectal Cancer

In the United States, the conventional approach to treating locally advanced rectal cancer has traditionally combined preoperative chemoradiotherapy, total mesorectal excision and adjuvant chemotherapy. The success of this tri-modality treatment has sparked interest in minimizing treatment-related morbidity by de-escalating locoregional therapy. Recent data, including findings from trials such as OPRA and PROSPECT, demonstrate the safety of omitting surgery or radiation, prompting a shift toward a patient-centered approach in rectal cancer treatment. This activity delves into various neoadjuvant treatment strategies aimed at reducing treatment-related morbidity while preserving the outstanding cure rates associated with standard therapy.

Topics:

  1. Omission of Radiation for Rectal Cancer
    Andrea Cercek, MD
  2. Q and A - Omission of Radiation for Rectal Cancer
    Andrea Cercek, MD
  3. Strategies for Rectal Preservation in Adenocarcinoma and Q&A
    Sarah J. Atkinson, MD
  4. Non-Operative Treatment of Patients with Rectal Cancer
    Te Vuong, MD
  5. Q and A
    Te Vuong, MD - Moderator
    Full Panel

This activity is available from June 17, 2025, through 11:59 p.m. Eastern time on June 16, 2027. 

The content was originally presented and recorded at the 2024 ASTRO Annual Meeting.

Target Audience

The activity is designed to meet the interests of medical oncologists, radiation oncologists, surgeons, nurses, physicists, diagnostic radiologists, pathologists, dosimetrists, radiation biologists, radiation therapists and residents.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Understand radiation approaches for non-operative management including role of short-course vs. long-course radiation and brachytherapy boost.
  • Understand patient selection for omission of radiation in the context of PROSPECT trial and immunotherapy data.
  • Understand indications for alternative surgical approaches to total mesorectal excision, including transanal local excision.
Course summary
Available credit: 
  • 1.00 AMA PRA Category 1 Credit™

    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

  • 1.00 Certificate of Attendance
    This activity was designated for 1.00 AMA PRA Category 1 Credit™.
Course opens: 
06/17/2025
Course expires: 
06/16/2027
Cost:
$149.00
Rating: 
0
  • Te Vuong, MD, is employed by McGill University and Jewish General Hospital. Dr. Vuong receives research/grant funding from Elekta and the JGH Foundation.
  • Andrea Cercek, MD, is employed by Memorial Sloan Kettering Cancer Center. Dr. Cercek serves in advisory roles with Abbvie, Amgen, Agenus, Daiichi Sankyo, Janssen, Merck, Pfizer/Seagen, Roche, GSK and Regeneron. Dr. Cercek receives grant/research funding from GSK and Seagen. 
  • Sarah J. Atkinson, MD, is employed by University of Washington. 

The person(s) above served as the developer(s) of this activity. Additionally, the ASTRO Education Committee had control over the content of this activity. All relevant financial relationships have been mitigated.

Disclosure link: 
ASTRO Education Committee

The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Available Credit

  • 1.00 AMA PRA Category 1 Credit™

    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

  • 1.00 Certificate of Attendance
    This activity was designated for 1.00 AMA PRA Category 1 Credit™.

Price

Cost:
$149.00
Please login or register to take this course.

Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the member rate.

  • Nonmember: $149
  • Member: $99
  • Member-in-Training: $49
  • Student/Graduate Student/PGY-1 Member: $49
  • Postdoctoral Fellow Member: $49

If you are an ASTRO member from a low or lower-middle income country, as identified by the World Bank, you can receive a 50% discount off your corresponding registration for this activity. Please email [email protected] to inquire about the discount.

Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the activity by the expiration date. 

Participants using ASTRO Academy activities to satisfy the requirement of a Continuing Certification (MOC) program should verify the credit number and type and availability dates of any activity before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased activities that do not align with their MOC requirement.

The activity and its materials will only be available on the ASTRO website until June 16, 2027, regardless of purchase date. At the expiration of the activity, participants will no longer have access to the activity or its materials. ASTRO reserves the right to remove an activity before its expiration date. 

Required Hardware/software

One of the two latest versions of Google Chrome, Mozilla Firefox, Internet Explorer or Safari.