Core Viewpoint - Colorectal cancer (CRC) is the third leading cause of cancer-related deaths globally, with over 30% of patients diagnosed at an advanced stage. Neoadjuvant radiotherapy plays a crucial role in both curative and palliative treatments, yet only 15%-30% of rectal cancer patients achieve pathological complete response (pCR), highlighting the need to understand mechanisms behind radiotherapy failure [2][5]. Group 1 - A new study published in Cell Reports Medicine identifies a subtype of cancer-associated fibroblasts (CAFs) called ilCAF, which responds positively to radiotherapy. Activation of the IFN-γ/STING signaling pathway in ilCAF enhances the effectiveness of radiotherapy and overcomes resistance [3][6]. - The study utilized single-cell RNA sequencing to discover ilCAF characterized by high expression of interferon regulatory factor-1 (IRF1), which is enriched in tumors that respond well to radiotherapy [6][9]. - The activation of the IFN-γ/STING signaling pathway reprograms the tumor microenvironment, enhancing anti-tumor immunity by attracting T cells and dendritic cells through the secretion of chemokines CCL4 and CCL5 [6][12]. Group 2 - The increase in ilCAF numbers enhances endogenous immune responses, contributing to improved overall survival rates in rectal cancer patients. The combination of STING agonists with radiotherapy shows significant translational potential for cancer treatment [9][12]. - Early initiation of the combined strategy of STING agonists and radiotherapy may enhance initial anti-tumor responses and mitigate the emergence of treatment resistance [9].