Colorectal cancer begins in the colon or rectum and often develops slowly from precancerous polyps. For patients with locally advanced rectal cancer (LARC), the current standard treatment is neoadjuvant chemoradiotherapy (CRT). However, not all patients respond in the same way, and there is a growing need to better understand the biological factors that determine treatment success.
The EU-funded STEPUPIORS project was created to address this challenge. Its mission is to identify biomarkers that can predict how each patient will respond to CRT by analyzing their tumour’s molecular profile both at diagnosis and during treatment. This knowledge could enable more precise and personalized treatment decisions: patients likely to benefit from CRT could be selected with greater confidence, while unnecessary toxicity and adverse effects could be avoided for those less likely to respond.
For patients who achieve a complete clinical response (cCR), less invasive surgery—or even a non-operative “watch-and-wait” approach—may be possible. These options can improve quality of life and reduce treatment costs. The project also aims to uncover new therapeutic targets for patients who do not respond well to CRT.
STEPUPIORS pursues three objectives:
1. Identify molecular signatures linked to CRT response through a newly formed rectal cancer consortium pooling complementary expertise.
2. Strengthen the research, management, and administrative capacities of the Institute for Oncology and Radiology of Serbia (IORS), including establishing a rectal cancer biobank.
3. Build long-term collaboration among participating institutions through sustained knowledge, personnel, and sample exchange.
The project aligns with Europe’s Beating Cancer Plan and the Horizon Europe Strategic Plan 2021–2024 within the health cluster
