Oxaliplatin-based preoperative chemoradiotherapy may yield more pathological complete responses (pCR) than fluorouracil-based therapy for patients with locally-advanced rectal cancer, according to a study published in the Journal of Clinical Oncology.1
In this 3-armed, randomized, phase 3 study, researchers evaluated whether oxaliplatin raises the likelihood of pCR with or without radiation, in comparison to fluorouracil.
A total of 495 patients were enrolled, of which 475 were evaluable; 155 received fluorouracil-radiotherapy, 157 received oxaliplatin-radiotherapy, and 163 received oxaliplatin only.
Among the 3 groups, pCR rates were: 14.0%, 27.5%, and 6.6% for fluorouracil-radiotherapy, oxaliplatin-radiotherapy, and oxaliplatin only, respectively; down-staging rates were 37.1%, 56.4%, and 35.5%, respectively.
The authors concluded that oxaliplatin-radiotherapy yielded the best pathological results, though oxaliplatin only led to similar down-staging results as fluorouracil-radiotherapy, yet without the radiation-associated complications and toxicities.
- Deng Y, Chi P, Lan P, et al. Modified FOLFOX6 with or without radiation versus fluorouracil and leucovorin with radiation in neoadjuvant treatment of locally advanced rectal cancer: initial results of the Chinese FOWARC multicenter, open-label, randomized three-arm phase III trial. J Clin Oncol. 2016 Aug 1. doi: 10.1200/JCO.2016.66.6198 [Epub ahead of print]