Rectal cancer response to neoadjuvant Chemoradiotherapy (pCRT) is highly variable.
In fact, it has been estimated that only about 21 % of patients show pathologic Complete
Response (pCR) after therapy, while in most of the patients a partial or incomplete tumour regression
is observed. Consequently, patients with a priori chemoradioresistant tumour should
not receive the treatment, which is associated with substantial adverse effects and does not
guarantee any clinical benefit. For Locally Advanced Rectal Cancer Patients (LARC), a standardized
neoadjuvant treatment protocol is applied, the identification and the usefulness of
prognostic or predictive biomarkers can improve the antitumoural treatment strategy, modifying
the sequence, dose, and combination of radiotherapy, chemotherapy and surgical resection.
For these reasons, a growing number of studies are actually focussed on the discovery and investigation
of new predictive biomarkers of response to pCRT. In this review, we have selected
the most recent literature (2012-2017) regarding the employment of blood-based biomarkers
potentially predicting pCR in LARC patients and we have critically discussed them to highlight
their real clinical benefit and the current limitations of the proposed methodological approaches.