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Introduction: Regorafenib is indicated as treatment in third-line and beyond in patients with metastatic colorectal cancer., Methods: This is a retrospective study of a cohort of patients with mCRC treated with regorafenib in Hospital Universitario Ramón y Cajal, in Madrid, Spain., Results: With the aim to assess the efficacy and safety of regorafenib, 91 patients treated between 2013 and 2023 were included. Only 1.1% of patients achieved disease control. Median progression free survival was 2.40 months and median overall survival was 4.76 months. The most frequent adverse events were fatigue and hand-foot skin reaction (59.34% and 28.57%, respectively)., Discussion: Our results confirm the safety of regorafenib as treatment of mCRC in real clinical practice. Although our population is less pretreated than in the CORRECT trial, our disease control rate was inferior. This difference may be due to a worse baseline status and a high percentage of hepatic disease showed in our patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Sotoca Rubio, Barrill Corpa, Alia Navarro, Pérez de Aguado Rodríguez, Moreno Doval, Calvo Pérez, Guerrero Serrano, García Merino, García de Quevedo Suero, Fernández-Fradejas, Serrano Domingo, Martínez Delfrade, Morón García, Ferreiro Monteagudo and de Frutos González.)

Immunotherapy has demonstrated a role in the therapeutic landscape of a small subset of patients with colorectal carcinoma (CRC) that harbor a microsatellite instability (MSI-H) status due to a deficient DNA mismatch repair (dMMR) system. The remarkable responses to immune checkpoint inhibitors (ICIs) are now being tested in the neoadjuvant setting in localized CRC, where the dMMR/MSI-H status can be found in up to 15% of patients, with remarkable results obtained in NICHE2 and 3 trials, among others. This case series aims to report our experience at a tertiary center and provide a comprehensive analysis of the possible questions and challenges to overcome if ICIs were established as standard of care in a neoadjuvant setting, as well as the potential role they may have as conversion therapy not only in locoregional advanced CRC but also in oligometastatic disease., Competing Interests: RF-M declares the following conflicts of interest—Advisory: Servier, Amgen, Pierre Fabre, Merck Sharp & Dohme (MSD); Speaker: Servier, Amgem, Merck, Pierre Fabre; Travels and other honoraria: Sanofi, Merck, Servier, Amgen. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 San-Román-Gil, Martínez-Delfrade, Albarrán-Fernández, Guerrero-Serrano, Pozas-Pérez, Chamorro-Pérez, Rosero-Rodríguez, Sotoca-Rubio, Barrill-Corpa, Alia-Navarro, González-Merino, García-de-Quevedo-Suero, López, Ruz-Caracuel, Perna-Monroy and Ferreiro-Monteagudo.)

Extrapulmonary small-cell carcinoma (SCC) is a rare neoplasm that shares certain features with its pulmonary counterpart and occurs predominantly in the gastrointestinal tract (GIT). It is a high-grade and poorly differentiated neuroendocrine tumor, usually diagnosed in advanced stages, with a poor prognosis and few therapeutic options in that setting. This is a case report of a 77-year-old Spanish male patient with localized SCC of the colon, who presented a pathological complete response in the surgical specimen after neoadjuvant chemotherapy with cisplatin and etoposide. To date, 5 years after surgery, the patient remains without evidence of tumor recurrence. As clinical guidelines for the management of this entity are lacking, and therefore its management has not been standardized, an attempt to summarize the current evidence in the literature was made.