An important milestone in rectal cancer care: the @FDA has granted accelerated approval of dostarlimab for adults with previously untreated stage II or III dMMR/MSI-H locally advanced rectal cancer. In 2022, the initial @NEJM report found a clinical complete response in all 12 patients who completed six months of dostarlimab. The result was striking, but came from a small cohort. The 2025 NEJM report expanded the evidence: all 49 patients with rectal cancer who completed treatment had a clinical complete response and chose nonoperative management. Two-year recurrence-free survival was 96% in this cohort. The approval was based primarily on AZUR-1, a multicenter phase 2 trial of 154 patients, with supporting data from the NEJM study. For eligible patients, this approach may help avoid chemoradiation and surgery, underscoring the importance of routine MMR/MSI testing at diagnosis. Close surveillance by an experienced multidisciplinary team remains critical, and longer follow-up is needed to confirm durability. #RectalCancer #Immunotherapy #ColorectalCancer #PrecisionOncology @AndreaCercek @MSKCancerCenter @ASCO @ASCRS_1 @GaertnerWB @SWexner

Could we safely extend surveillance colonoscopy intervals after high-risk adenoma removal? A randomized trial published in @NEJM challenges the traditional 3-year surveillance interval for patients with high-risk colorectal adenomas. The EPoS II trial randomized 10,799 patients to surveillance colonoscopy at 3 versus 5 years following polyp removal. Key findings at 5 years: -Colorectal cancer incidence: 0.82% (3-year group) vs. 0.77% (5-year group). -The 5-year strategy met the prespecified criterion for noninferiority. -Cancer stage at diagnosis did not differ substantially between groups. These findings raise an important question: Can we safely extend surveillance intervals without compromising colorectal cancer prevention? The implications could be significant for optimizing surveillance practices, improving endoscopy capacity, and expanding access to colorectal cancer screening. Importantly, these are interim findings from an ongoing 10-year trial and current surveillance guidelines remain unchanged pending further evidence and guideline review. #ColorectalCancer #Colonoscopy #ColorectalSurgery #CancerPrevention #EvidenceBasedMedicine @ASCRS_1 @AmericanCancer @SWexner @ASGEendoscopy @AmCollegeGastro @DouglasAdlerMD