The current landscape of neoadjuvant therapy for resectable colon cancer

Introduction: Neoadjuvant therapy has been proposed as a safe and effective treatment option for resectable colon cancer, providing several advantages over the current standard adjuvant protocol. Areas covered: This review summarizes the recent developments in neoadjuvant strategies for resectable colon cancer, highlighting key clinical trial data, current and emerging challenges, and the role of precision medicine in guiding treatment. Sources for this review were obtained through searches of PubMed, ClinicalTrials.gov, and relevant conference abstracts. Expert opinion: Neoadjuvant therapy is emerging as a promising approach for treating colon cancer, especially for dMMR/MSI-H colon cancer where neoadjuvant immunotherapy have shown exceptional complete pathologic response rates and durable responses. Ongoing trials are focused on identifying optimal treatment approaches that balance oncological efficacy with the minimization of toxicity. A reliable multimodal evaluation framework incorporating advanced staging techniques and biomarkers such as circulating tumor DNA is essential to guide treatment and improve patient selection.