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.


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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.

Reference

  1. 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]