Oxaliplatin, fluorouracil, and leucovorin versus fluorouracil and leucovorin as adjuvant chemotherapy for locally advanced rectal cancer after preoperative chemoradiotherapy (ADORE): an open-label, multicentre, phase 2, randomised controlled trial

Hong, Yong Sang; Nam, Byung Ho; Kim, Kyu Pyo; Kim, Jeong Eun; Park, Seong Joon; Park, Young Suk; Park, Joon Oh; Kim, Sun Young; Kim, Tae You; Kim, Jee Hyun; Ahn, Joong Bae; Lim, Sangwoo; Yu, Chang Sik; Kim, Jin Cheon; Yun, Seong Hyeon; Kim, Jong Hoon; Park, Jin hong; Park, Hee Chul; Jung, Kyung Hae; Kim, Tae Won

doi:10.1016/s1470-2045(14)70377-8

Cited by 341 publications

(207 citation statements)

References 33 publications

Supporting

Mentioning

199

Contrasting

Unclassified

Order By: Relevance

“…Eine randomisierte Phase-II-Studie aus Südkorea (ADORE) fand ein signifikant verbessertes krankheitsfreies Überleben für Patienten im ypTNM-Stadium II/III nach neoadjuvanter 5-Fluorouracilbasierter Radiochemotherapie für die adjuvante Chemotherapie mit FOLFOX versus 5-FU/Folinsäure-Bolus-Regime [1037] (▶ Tab. 4).…”

Section: Level Of Evidenceunclassified

S3-Leitlinie – Kolorektales Karzinom

Schmiegel

Buchberger

Follmann³

et al. 2017

Z Gastroenterol

131

View full text Add to dashboard Cite

Section: Level Of Evidenceunclassified

S3-Leitlinie – Kolorektales Karzinom

Schmiegel

Buchberger

Follmann³

et al. 2017

Z Gastroenterol

131

View full text Add to dashboard Cite

“…Based on these encouraging results, several trials were carried out to determine the benefits of oxaliplatin in addition to standard fluopyridinaminebased regimens in rectal cancer (ACCORD12/0405Prodige, CAO/ARO/AIO04, ADORE, STAR01, NSAPB R04, PETACC6) [7378] . While some studies reported significant improvement in pathological response and diseasefree survival [76,78] , others found no superiority of oxaliplatin, but instead an increased risk of acute toxicity [74,75,77,79] . Only four trials reported the data on survival.…”

Section: Oxaliplatin-based Regimensmentioning

confidence: 99%

Adjuvant chemotherapy for rectal cancer: Is it needed?

Milinis

Thornton

Montazeri

et al. 2015

WJCO

View full text Add to dashboard Cite

Adjuvant chemotherapy has become a standard treatment of advanced rectal cancer in the West. The benefits of adjuvant chemotherapy after surgery alone have been well established. However, controversy surrounds the use adjuvant chemotherapy in patients who received preoperative chemoradiotherapy, despite it being recommended by a number of international guidelines. Results of recent multicentre randomised control trials showed no benefit of adjuvant chemotherapy in terms of survival and rates of distant metastases. However, concerns exist regarding the quality of the studies including inadequate staging modalities, out-dated chemotherapeutic regimens and surgical approaches and small sample sizes. It has become evident that not all the patients respond to adjuvant chemotherapy and more personalised approach should be employed when considering the benefits of adjuvant chemotherapy. The present review discusses the strengths and weaknesses of the current evidence-base and suggests improvements for future studies.

show abstract

“…Furthermore, in a multi-center randomized trial of patients with pathological stage 2 or 3 rectal cancer after preoperative fluoropyrimidine-based chemoradiotherapy and TME, the addition of oxaliplatin to fluorouracil and leucovorin (FOLFOX) improved the 3-year disease-free survival (71.6%) when compared with that of the fluorouracil plus leucovorin group (62.9%) (hazard ratio, 0.657; p=0.047); thus, further investigation of different potential regimens as complementary to neoadjuvant chemoradiotherapy protocols is recommended (17). Finally, after a median follow-up of 11 years, the German Rectal Cancer Study Group reported a small but statistically significant benefit solely in local relapse (7% vs. 10%, respectively, in the Groups NA and A; p=0.048) and no differences in OS and disease-free survival (18).…”

Section: Type Of Complication (N %)mentioning

confidence: 99%

Adjuvant versus neoadjuvant chemoradiotherapy in distal rectal cancer: Comparison of two decades in a single center

Zengel

Uslu

Adıbelli

et al. 2015

UCD

View full text Add to dashboard Cite

Adjuvant versus neoadjuvant chemoradiotherapy in distal rectal cancer: Comparison of two decades in a single center Objective: Standard surgery alone was not able to decrease local recurrence (LR) rate below 20% in rectal cancer treatment. Thus, many centers administered neoadjuvant radiotherapy (preopRTx) with or without concomitant chemotherapy for the prevention of LR. In this study, the results of 164 consecutive patients with mid-and distal rectal cancer who received surgery and adjuvant chemoradiotherapy (Group A) or neoadjuvant chemoradiotherapy (Group NA) followed by surgery are presented. Material and Methods:The staging system used in this study is that of the American Joint Committee on Cancer (AJCC), also known as the TNM system. Eligible patients were required to have radiologically assessed stage 1 (only T2N0M0) to stage 3C (T4bN1-2M0) tumor with pathologically confirmed R0 resection. The surgical method was total mesorectal excision (TME). Radiotherapy was applied with daily 180 cGy fractions for 28 consecutive days. Chemotherapy Results: Nine patients (13%) in Group NA achieved pathologic complete response (pCR). In Group NA and Group A, locoregional recurrence (LRR) rates were 6.7% and 30.8%, (p<0.001), the mean LR-free survival was 190.0±7.3 months and 148.0±11.7 months (p=0.002) and the mean overall survival (OS) was 119.2±15.3 months and 103.0±9.4 months (p=0.23), respectively. A significant difference with regard to LR has been obtained with a statistical power of 0.92. Secondary outcome measures (DFS and OS) have not been met. Conclusion:Neoadjuvant chemoradiotherapy with TME is an efficient treatment protocol, particularly for the treatment of magnetic resonance imaging-staged 2A to 3C patients with two or three distal rectal adenocarcinomas. Given that a considerable proportion of patients with cT2N0M0 would develop pCR, this method of treatment can be considered for further studies.

show abstract

Oxaliplatin, fluorouracil, and leucovorin versus fluorouracil and leucovorin as adjuvant chemotherapy for locally advanced rectal cancer after preoperative chemoradiotherapy (ADORE): an open-label, multicentre, phase 2, randomised controlled trial

Cited by 341 publications

References 33 publications

S3-Leitlinie – Kolorektales Karzinom

S3-Leitlinie – Kolorektales Karzinom

Adjuvant chemotherapy for rectal cancer: Is it needed?

Adjuvant versus neoadjuvant chemoradiotherapy in distal rectal cancer: Comparison of two decades in a single center

Contact Info

Product

Resources

About