Short-course Radiotherapy Combined With CapeOx and PD-1 Inhibitor After Local Excision for High-risk Early Rectal Cancer (TORCH-LE)

This study (TORCH-LE) tests whether short-course radiation combined with a chemotherapy regimen (capecitabine + oxaliplatin, called CapeOx) and a PD-1 immunotherapy drug can safely replace full radical surgery in patients with early rectal cancer that was removed by local excision but has high-risk features suggesting incomplete treatment. **You may be eligible if...** - You are aged 18–75 with rectal cancer that was removed by local excision (not full bowel resection) - Your tumor is within 7 cm of the anus and was found to have high-risk features (e.g., positive margins, deep invasion, lymphovascular invasion, high grade) - You have refused radical surgery - You have not received any prior cancer treatment - Your cancer is microsatellite stable (MSS/pMMR) **You may NOT be eligible if...** - You are pregnant or breastfeeding - Your cancer has spread to the pelvis or other organs - You have a serious medical condition such as uncontrolled heart disease or severe infection - You have a DPD enzyme deficiency (which affects how capecitabine is broken down) Talk to your doctor to see if this trial is right for you.