Oxaliplatin and bevacizumab disappoint for rectal cancer
The addition of bevacizumab and oxaliplatin to standard neoadjuvant chemoradiotherapy does not enhance clinical response rates in rectal cancer, show phase II study results.
CONCLUSION: Despite extensive research and promising preclinical studies, a definite further agent in addition to fluoropyrimidines that consistently improves response rate has yet to be found. PMID: 30311641 [PubMed - in process]
This phase II feasibility study explores the long-term oncological outcomes and health-related quality of life of patients with cT1-3N0M0 rectal cancer who underwent neoadjuvant chemoradiotherapy followed by transanal endoscopic microsurgery.
AbstractPurpose of ReviewThis review summarizes the relevant literature on the use of total neoadjuvant therapy (TNT) for patients with locally advanced rectal cancer. It highlights the most notable literature published and briefly discusses future directions.Recent FindingsRecent randomized trials evaluating TNT show improved rates of pathologic complete response and patient treatment tolerance with this approach.SummaryThe rationale for TNT includes the poor patient tolerance of adjuvant chemotherapy and the persistent risk of distant disease in patients with locally advanced rectal cancer, despite improvements in local ...
ConclusionIn patients undergoing post-ICT MRI, tumour volume did not correlate with TNT response, but decreased lymph node sizes were significantly associated with complete response to TNT as well as DFS. Relative T2SI showed borderline correlation with TNT response.Key Points• MRI-based tumour volume after induction chemotherapy and before chemoradiotherapy did not correlate with overall tumour response at the end of all treatment.• Lymph node size after induction chemotherapy and before chemoradiotherapy was strongly associated with complete pathological response after all treatment.• Lymph node sizes at b...
The aim of the present study was to evaluate the long-term results of laparoscopic curative resection for rectal cancer. We included all patients who underwent laparoscopic curative resection for rectal cancer from June 2005 to September 2015. A total of 159 patients were included; 33.9% received neoadjuvant chemoradiotherapy. Thirty-day mortality and morbidity rates were 0.6% and 26.4%, respectively. Pathologic stage was 0 in 12%, I in 39%, II in 24.5%, and III in 24.5%. The median number of lymph nodes harvested was 16. In 5% of patients, mesorectal excision was incomplete. Median follow-up was 59 months. Overall 5-year ...
ConclusionsHere we report the completion rates for neoadjuvant CTx and adjuvant CTx, the pathological complete response rate, and the mid-term prognosis. The results indicate that CAPOX followed by TME may be a safe treatment strategy for locally advanced rectal cancer.
ConclusionsTIC visual inspection may be one of the potential biomarkers over morphological analysis using DCE-MRI data to assess pathological response after pCRT in LARC.
ConclusionTRG is a prognostic factor for both OS and DFS but does not appear to have a significant benefit for the selection of patients with LARC treated with NACRT who might benefit from the administration of ACT. Prospective randomized trials with larger populations are needed to identify factors that predict which patients may benefit from the administration of ACT.
Conclusion: Preliminary results are encouraging. FOLFOXIRI regimen plus targeted agents followed by CRT and surgery seems a safe approach. Longer follow-up and higher number of patients are mandatory to confirm such findings. PMID: 30263096 [PubMed]
Journal of Surgical Oncology, EarlyView.