Neoadjuvant Chemotherapy With mFOLFOXIRI Without Routine Use of Radiotherapy for Locally Advanced Rectal Cancer

Zhang, Jianwei; Huang, Meijin; Cai, Yue; Wang, Lei; Xiao, Jian; Lan, Ping; Hu, Huabin; Wu, Xiaojian; Ling, Junqi; Peng, Junsheng; Chen, Dianke; Kang, Liang; Zhang, Yan; Ren, Donglin; Wang, Hui; Chen, Shuang; Lin, Feng; Zheng, Jian; Zhou, Zhiyang; Wang, Jianping; Deng, Yanhong

doi:10.1016/j.clcc.2019.07.001

Cited by 30 publications

(23 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The new attempts of selective NRT or the omission of NRT that have recently emerged in our center (NCT01211210, NCT02217020, etc.) 17,18 have provided a direct comparison between NCRT and NCT, which is ideal for determining the impact of MMR status on response to NRT. This is the first study to utilize multicenter data to investigate this issue in locally advanced rectal cancer.…”

Section: Introductionmentioning

confidence: 99%

Association of mismatch repair status with survival and response to neoadjuvant chemo(radio)therapy in rectal cancer

Cheng

Zhang

et al. 2020

npj Precis. Onc.

Self Cite

View full text Add to dashboard Cite

Prior reports have indicated that defective mismatch repair (MMR) has a favorable impact on outcome in colorectal cancer patients treated with surgery, immunotherapy, or adjuvant chemotherapy. However, the impact of MMR status on response to neoadjuvant radiotherapy in rectal cancer is not well understood. Here we report that dMMR was associated with improved disease-free survival (DFS) (P = 0.034) in patients receiving neoadjuvant chemotherapy (NCT). Patients with dMMR tumors who received neoadjuvant chemoradiotherapy (NCRT) achieved significantly worse DFS (P = 0.026) than those treated with NCT. Conversely, NCRT improved DFS (P = 0.043) in patients with pMMR tumors, especially for stage III disease with improved DFS (P = 0.02). The presence of dMMR was associated with better prognosis in rectal cancer patients treated with NCT. NCT benefited patients with dMMR tumors; while NCRT benefited patients with stage III disease and pMMR tumors. Patients stratified by MMR status may provide a more tailored approach to rectal cancer neoadjuvant therapy.

show abstract

Section: Introductionmentioning

confidence: 99%

Association of mismatch repair status with survival and response to neoadjuvant chemo(radio)therapy in rectal cancer

Cheng

Zhang

et al. 2020

npj Precis. Onc.

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, with increasing focus on neoadjuvant chemotherapy, the value of preoperative radiation, especially in patients with initially resectable tumors that undergo high-quality TME surgery, is under question. Recently, several randomized studies have reported non-inferior survival outcomes in those receiving neoadjuvant chemotherapy without radiation (12,13,16,17), which has prompted a reexamination of the significance of preoperative radiation.…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, use of neoadjuvant chemotherapy alone was reported to result in promising survival outcomes (12,13). The FORWARC (13) study showed that 3-year DFS rates in those undergoing mFOLFOX6 with and without routine radiation did not significantly differ, and the elimination of radiation was unlikely to increase local recurrence risk after R0/1 resection.…”

Section: Introductionmentioning

confidence: 99%

Prolonged neoadjuvant chemotherapy without radiation versus total neoadjuvant therapy for locally advanced rectal cancer: A propensity score matched study

Zhao

Han

et al. 2022

Front. Oncol.

View full text Add to dashboard Cite

BackgroundAlthough neoadjvuant chemoradiotherapy (CRT) improves the local control rate of locally advanced rectal cancer (LARC), it fails to significantly improve disease-free survival (DFS) and overall survival (OS). We explored the efficacy of prolonged neoadjuvant chemotherapy (pNCT) without radiation and compared this schema with total neoadjuvant therapy (TNT).Material and methodsPatients diagnosed with LARC and received TNT (4 cycles of induction CapeOX/FOLFOX followed with CRT) or pNCT (6~8 cycles of CapeOX/FOLFOX) between June 2016 and October 2021 were retrospective analyzed. All patients underwent total mesorectal excision (TME). A 1:1 propensity score match was performed to adjust baseline potential confounders. The tumor response, toxicity, recurrence-free survival (RFS) and OS were observed.ResultsA total of 184 patients with 92 patients in each group were finally enrolled. The median follow-up time was 35 months. TNT showed better pathological complete response (pCR) rate (25.0% vs 16.3%) and objective regression rate (73.9% vs 59.8%) than pNCT. TNT and pNCT produce similar 3-year RFS and OS rates in patients with mid-to-upper rectal cancer. TNT was associated with improved tumor responsiveness in all patients and improved 3-year RFS rates in those with low rectal cancer.ConclusionpNCT is an option for patients with mid-to-upper rectal cancer, but radiation is still necessary for low rectal cancer. To determine optimal schema for neoadjuvant therapy and patient selection, additional randomized controlled studies are needed.

show abstract

“…In recent years, the studies of immune checkpoint inhibitors (ICIs) in various tumors are growing vigorously, and the results have shown that ICIs have good therapeutic effect. Immunotherapy is claimed to significantly improve the prognosis of colorectal cancer patients, and ICIs have also been recommended as a first-line option for advanced rectal cancer [4][5][6][7]. Related studies suggest that ICIs show good effects in the neoadjuvant treatment of resectable rectal cancer; meanwhile, ICI drugs also have a great potential in the comprehensive treatment decision-making of locally advanced and early rectal cancer.…”

Section: Introductionmentioning

confidence: 99%

Efficacy Analysis of Combining Sintilimab with Neoadjuvant Chemotherapy in Treating Middle and Advanced Rectal Cancer Based on Big Data

Wang

Jiandong

Zheng

et al. 2022

Journal of Oncology

View full text Add to dashboard Cite

Objective. To analyze the efficacy of combining sintilimab with neoadjuvant chemotherapy in treating middle and advanced rectal cancer based on big data. Methods. According to the inclusion and exclusion criteria, 43 patients with middle and advanced rectal cancer, who were treated with sintilimab and neoadjuvant chemotherapy in General Surgery of the hospitals of Zhangjiakou city from January 2020 to January 2022, were selected for the retrospective study. The patients' short-term efficacy was scientifically evaluated, and the factors affecting efficacy and the correlation were analyzed. Results. Among the 43 enrolled patients, 30 of them had regional lymphatic metastasis but none had distant metastasis; most patients were at Broders II and TNM III, and all of them had adenocarcinoma; the total response rate was 69.77% (30 cases), with no grade IV and V adverse reactions; the patients were divided into the effective group and the ineffective group after treatment based on the evaluation results of shortterm efficacy, and analysis of the relevant factors exposed in both groups revealed significant differences in age, tumor size, CEA, NLR value, PLR value, TNM stage, and presence of combined lymphatic metastasis between the two groups (P < 0:05); univariate analysis showed that tumor size, CEA, TNM stage, and combined lymphatic metastasis were the independent risk factors affecting the efficacy in patients with middle to advanced rectal cancer (P < 0:05); and through the Spearman correlation analysis of the above independent risk factors, it was further confirmed that tumor size, CEA, TNM stage, and combined lymphatic metastasis were negatively correlative with the efficacy of combining sintilimab with neoadjuvant chemotherapy in treating middle to advanced rectal cancer (P < 0:05). Conclusion. Combining sintilimab with neoadjuvant chemotherapy has good efficacy and safety profile, which is conducive to subsequent surgery; in contrast, larger tumor diameter, higher CEA level, higher TNM stage, and more serious lymphatic metastasis are all independent risk factors affecting treatment sensitivity and can lead to poor efficacy.

show abstract

Neoadjuvant Chemotherapy With mFOLFOXIRI Without Routine Use of Radiotherapy for Locally Advanced Rectal Cancer

Cited by 30 publications

References 26 publications

Association of mismatch repair status with survival and response to neoadjuvant chemo(radio)therapy in rectal cancer

Association of mismatch repair status with survival and response to neoadjuvant chemo(radio)therapy in rectal cancer

Prolonged neoadjuvant chemotherapy without radiation versus total neoadjuvant therapy for locally advanced rectal cancer: A propensity score matched study

Efficacy Analysis of Combining Sintilimab with Neoadjuvant Chemotherapy in Treating Middle and Advanced Rectal Cancer Based on Big Data

Contact Info

Product

Resources

About