Pre-operative Targeted Treatments in Molecularly Selected Resectable Colorectal Cancer (UNICORN)

Inclusion Criteria: General inclusion criteria * Provide a signed and dated informed consent document. * Age ≥ 18 years at time of informed consent. * ECOG PS of 0 and 1. * Histologically confirmed colorectal cancer adenocarcinoma that is judged as initially resectable with elective surgery aimed at radical intent with R0 margins as per multidisciplinary team assessment. * Radiological stage cT3-4, N0-2, M0 using computed tomography (CT) as in the pivotal FOxTROT study. * Patients with rectal cancer candidate for R0 resection, not requiring pre-operative radiotherapy based on multidisciplinary team assessment, with the following characteristics on high-resolution thin slice (3 mm) contrast-enhanced magnetic resonance imaging (MRI): * ≤ T3a defined at the MRI (perivisceral fat infiltration \<2 mm) and clinical N0 * Upper-medium, defined as tumors with distal margin ≥ 5 cm from the anal verge. * Absence of mesorectal fascia invasion, as defined as a distance ≥ 1 mm between tumor and the mesorectal fascia. * Able to provide enough archival FFPE tumor specimen that is already available from initial diagnostic procedures for the purpose of molecular pre-screening. * Presence of one of the selected molecular profile/alteration after central pre-screening and necessary for the assignment to a matching treatment cohort. * No prior systemic treatment for colorectal cancer or neoadjuvant radiation therapy for rectal cancer. * Adequate bone marrow function (absolute neutrophil …