Irinotecan Liposome Plus Capecitabine and Enronsubemab Combined With Short-course Radiotherapy for Neoadjuvant Treatment of Locally Advanced Rectal Cancer

This trial is testing a neoadjuvant (pre-surgery) combination of four treatments — a liposomal chemotherapy drug (irinotecan liposome), capecitabine (oral chemo), an immunotherapy drug (enronsubemab), and short-course radiation — for locally advanced rectal cancer. **You may be eligible if...** - You are 18–75 years old - You have locally advanced rectal cancer confirmed by biopsy (cT3–4 or lymph node positive), with the tumor within 10 cm of the anus - You have not received any prior cancer treatment for rectal cancer - Your tumor is measurable on scan - You are in good physical condition (ECOG 0–1) with at least 12 months expected survival - Your blood counts, liver, kidney, and clotting function are within acceptable limits **You may NOT be eligible if...** - You have had another cancer in the past 5 years (with some exceptions) - Your tumor is MSI-H or dMMR type (a subtype that responds differently to treatment) - You have significant bleeding, blood clots, or are on long-term anticoagulants - Your cancer has spread widely (e.g., to the lining of the abdominal cavity or multiple bones/brain) - You had major surgery in the past 4 weeks - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.