Neoadjuvant chemotherapy with CapeOx alone vs standard chemoradiotherapy (CRT) with Capecitabine for patients with LARC

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Published: 20 Sep 2021
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Dr Pei-Rong Ding - Sun Yat-sen University Cancer Center, Guangzhou, China

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 multicentre 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.

ecancer's filming has been kindly supported by Amgen through the ecancer Global Foundation. ecancer is editorially independent and there is no influence over content.