SPAG1 and rectal cancer: Components of the IL-4 signaling pathway such as ALOX5, EGR1, SPAG1, NCF2, and ATXN1 are known to affect the immune response (Lee et al., 2009; Rajaraman et al., 2009; Siliņa et al., 2011; Li et al., 2019; Didonna et al., 2020; Wei et al., 2020); their regulation by VSTM2L induced chemoradiotherapy resistance in rectal cancer through downstream IL-4 signaling which subsequently affects the progress of cell proliferation and apoptosis (Liu et al., 2021).