Dr Peirong Ding talks to ecancer about his study combining neoadjuvant chemotherapy with oxaliplatin and capecitabine versus chemoradiation with capecitabine for locally advanced rectal cancer with uninvolved mesorectal fascia. These are the initial results of a multicenter randomised, open-label, phase III trial.
Dr Ding talks about the current standard therapy, being chemoradiation, saying the benefit is very good local control with only 5-6% recurrence for LARC after chemoradiation. However overall survival has not been improved under this treatment strategy. Chemoradiation is also linked to toxicity and impaired long-term quality of life.
The methodology involved 663 patients (331 in nCT arm; 332 in nCRT arm) meeting inclusion criteria. 86.3% of patients accomplished full dose of neoadjuvant therapy in
nCT arm compared to 91.0% in nCRT arm. 52.8% of patients accomplished full dose of adjuvant chemotherapy in nCT arm compared to 44.1% in nCRT arm. The pCR rate and good downstaging rate in nCT arm and nCRT arm was 11.0% vs. 13.8%, and 40.8% vs. 45.6%, respectively
The results showed that nCT achieved similar pCR and a good downstaging rate with less perioperative distance metastasis and preventive colostomy compared to nCRT. This
regimen could serve as a potential alternative to CRT in LARC with uninvolved MRF.
Long-term follow-up is needed to confirm these results.
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