Chemotherapy induction followed by preoperative chemoradiation versus preoperative chemoradiation alone in locally advanced rectal cancer (LARC): A randomized controlled phase II study.

Maréchal, Raphaël; Vos, Bertrand; Polus, Marc; Delaunoit, T.; Peeters, M.J.T. Baas-Vrancken; Demetter, P.; Houtte, Paul Van; Demols, A.; Stadt, J. Van de; Laethem, J. Van

doi:10.1200/jco.2010.28.15_suppl.3637

Cited by 5 publications

(3 citation statements)

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“…Several phase II trials have now generated results of neoadjuvant chemotherapy (NACT) followed by CRT ( Table 3 ). Although the survival data seem promising, the two randomized phase II studies comparing upfront CRT with NACT followed by CRT failed to demonstrate improvements in either pCR rate or R0 resection probability [ 94 , 95 ]. Investigators from the AVACROSS study, who incorporated bevacizumab in both the NACT and CRT regimens, found an impressive pCR rate 36% while 98% of patients were able to undergo an R0 resection [ 96 ].…”

Section: Novel Chemotherapy Treatment Strategiesmentioning

confidence: 99%

Progress in Rectal Cancer Treatment

Ceelen

2012

ISRN Gastroenterology

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The dramatic improvement in local control of rectal cancer observed during the last decades is to be attributed to attention to surgical technique and to the introduction of neoadjuvant therapy regimens. Nevertheless, systemic relapse remains frequent and is currently insufficiently addressed. Intensification of neoadjuvant therapy by incorporating chemotherapy with or without targeted agents before the start of (chemo)radiation or during the waiting period to surgery may present an opportunity to improve overall survival. An increasing number of patients can nowadays undergo sphincter preserving surgery. In selected patients, local excision or even a “wait and see” approach may be feasible following active neoadjuvant therapy. Molecular and genetic biomarkers as well as innovative imaging techniques may in the future allow better selection of patients for this treatment option. Controversy persists concerning the selection of patients for adjuvant chemotherapy and/or targeted therapy after neoadjuvant regimens. The currently available evidence suggests that in complete pathological responders long-term outcome is excellent and adjuvant therapy may be omitted. The results of ongoing trials will help to establish the ideal tailored approach in resectable rectal cancer.

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Section: Novel Chemotherapy Treatment Strategiesmentioning

confidence: 99%

Progress in Rectal Cancer Treatment

Ceelen

2012

ISRN Gastroenterology

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“…Another randomized phase II study from Belgium tested two cycles of modified FOLFOX6 regimen (oxaliplatin 100 mg/m², folinic acid 400 mg/m², 5-FU bolus 400 mg/m² followed by 2 g/m² as continuous infusion, d1 and d15) before preoperative CRT (45 Gy with 5-FU 250 mg/m²/day continuous infusion during RT) versus the same schedule of preoperative CRT alone [20]. In an interim analysis presented at ASCO 2010 (28 vs. 29 patients analyzed), the arm with induction chemotherapy was feasible and did not compromise CRT completion or surgery.…”

Section: Induction Chemotherapy Prior To Preoperative Chemoradiotherapymentioning

confidence: 99%

Induction Chemotherapy before Chemoradiotherapy and Surgery for Locally Advanced Rectal Cancer

Rödel

Arnold²,

Becker³

et al. 2010

Strahlenther Onkol

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“…However, sphincter preservation rates showed a trend favoring induction chemotherapy (100% vs 67%; P=.058). 66 A second randomized phase II trial showed improved tolerance of CAPOX (capecitabine and oxaliplatin) in the neoadjuvant versus adjuvant setting but no change in pathologic response rates or 3-year survival. This trial was confounded by integration of concurrent CAPOXbased radiotherapy.…”

Section: Preoperative Induction Chemotherapy Integrating Oxaliplatinmentioning

confidence: 99%

Multidisciplinary Management of Locally Advanced Rectal Cancer: Neoadjuvant Approaches

Murugappan

Harris

Willett

et al. 2013

J Natl Compr Canc Netw

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Although tumor biology and genomics of colon and rectal cancer are no different, patients with locally advanced rectal cancer (LARC) require neoadjuvant fluoropyrimidine-based chemoradiation and total mesorectal excision. In addition to known clinical risk factors, improved algorithms integrating molecular tools are needed to stratify patients with LARC to improve treatment outcomes and reduce acute and long-term toxicities. Simply combining newer systemic or targeted agents with standard treatment in all patients yielded little success but added toxicities. This article reviews the historical data, current standards of care, and ongoing research efforts regarding biomarkers, molecular imaging, and personalized genomic information.

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Chemotherapy induction followed by preoperative chemoradiation versus preoperative chemoradiation alone in locally advanced rectal cancer (LARC): A randomized controlled phase II study.

Cited by 5 publications

References 0 publications

Progress in Rectal Cancer Treatment

Progress in Rectal Cancer Treatment

Induction Chemotherapy before Chemoradiotherapy and Surgery for Locally Advanced Rectal Cancer

Multidisciplinary Management of Locally Advanced Rectal Cancer: Neoadjuvant Approaches

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