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ASCO 2026 | Enhancing immunogenicity in rectal cancer with chemo-radioimmunotherapy

Ali Shamseddine, MD, Basile Cancer Institute at the American University of Beirut, Beirut, Lebanon, comments on the concept of combining short-course radiation therapy with chemotherapy and immunotherapy to enhance the immunogenic effect in rectal cancer. This combination, including the use of checkpoint inhibitors like avelumab, can potentiate the abscopal effect and lead to a higher pathologic complete response locally. This interview took place during the 2026 American Society of Clinical Oncology (ASCO) Meeting in Chicago, IL.

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Transcript

As we alluded to before, the short course radiation specifically will enhance the immunogenic effect, but it is a weak effect. And we notice that in a certain type called abscopal effect. So once you have focal radiation therapy, at one side you get a response on the other side, this we call what they call the abscopal effect, so it is a weak effect with the use of chemotherapy like oxaliplatin and new checkpoint inhibitors, this weak effect potentiates and becomes more evident clinically, so this is the new concept of using the combination of short-course radiation therapy, chemo plus immunotherapy, with here Avelumab, to enhance the immunogenic effect of short-course radiation therapy...

As we alluded to before, the short course radiation specifically will enhance the immunogenic effect, but it is a weak effect. And we notice that in a certain type called abscopal effect. So once you have focal radiation therapy, at one side you get a response on the other side, this we call what they call the abscopal effect, so it is a weak effect with the use of chemotherapy like oxaliplatin and new checkpoint inhibitors, this weak effect potentiates and becomes more evident clinically, so this is the new concept of using the combination of short-course radiation therapy, chemo plus immunotherapy, with here Avelumab, to enhance the immunogenic effect of short-course radiation therapy. And this translates to a higher pathologic complete response locally. And we have several new trials, but in our trial specifically, the new aspect in our trial is the concept of immunoscore to predict the outcome in those patients, specifically those with initial pre-treatment biopsy, with a high immunoscore.

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