Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • Vaccine Hub
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
  • Fact Check
  • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • Fact Check
      • Bone Health Fact Check
      • Brain Health Fact Check
      • Cancer Related Fact Check
      • Child Care Fact Check
      • Dental and oral health fact check
      • Diabetes and metabolic health fact check
      • Diet and Nutrition Fact Check
      • Eye and ENT Care Fact Check
      • Fitness fact check
      • Gut health fact check
      • Heart health fact check
      • Kidney health fact check
      • Medical education fact check
      • Men's health fact check
      • Respiratory fact check
      • Skin and hair care fact check
      • Vaccine and Immunization fact check
      • Women's health fact check
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Abroad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • Fact Check
    • Bone Health Fact Check
    • Brain Health Fact Check
    • Cancer Related Fact Check
    • Child Care Fact Check
    • Dental and oral health fact check
    • Diabetes and metabolic health fact check
    • Diet and Nutrition Fact Check
    • Eye and ENT Care Fact Check
    • Fitness fact check
    • Gut health fact check
    • Heart health fact check
    • Kidney health fact check
    • Medical education fact check
    • Men's health fact check
    • Respiratory fact check
    • Skin and hair care fact check
    • Vaccine and Immunization fact check
    • Women's health fact check
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Abroad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Oncology
  • Oncology News
  • Chemoradiotherapy may...

Chemoradiotherapy may be safely omitted in some patients with locally advanced rectal cancer: PROSPECT trial

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-06-11T20:00:25+05:30  |  Updated On 11 Jun 2023 8:00 PM IST
Chemoradiotherapy may be safely omitted in some patients with locally advanced rectal cancer: PROSPECT trial
  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • Email

USA: Findings from the PROSPECT trial have shown preoperative FOLFOX to be non-inferior to preoperative chemoradiotherapy for disease-free survival among patients with locally advanced rectal cancer eligible for sphincter-sparing surgery.

The findings were presented at the 2023 ASCO Annual Meeting (Abstract LBA2) and subsequently published in the Journal of Clinical Oncology (patient-reported outcomes data) and The New England Journal of Medicine (efficacy data). The findings imply that omitting radiation therapy can decrease short- and long-term side effects impacting the quality of life and provides similar outcomes in overall and disease-free survival.

Pelvic radiation combined with sensitizing chemotherapy with fluoropyrimidine (chemoradiotherapy) before surgery is standard care for locally advanced rectal cancer in North America. There is no knowledge on whether neoadjuvant chemotherapy with FOLFOX (fluorouracil, leucovorin, and oxaliplatin) can be used instead of chemoradiotherapy.

To fill this knowledge gap, Deborah Schrag, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, and colleagues conducted an unblinded, multicenter, noninferiority, randomized trial of neoadjuvant FOLFOX (with chemoradiotherapy given only if the primary tumour reduced in size by <20% or if FOLFOX was discontinued due to side effects) as compared with chemoradiotherapy.

The phase III PROSPECT trial enrolled 1,194 patients with rectal cancer that had spread to nearby tissue or lymph nodes but had not spread to distant organs and who were candidates for sphincter-sparing surgery. Patients were randomly assigned to the chemoradiation therapy group (control) or the modified FOLFOX6 chemotherapy with selective use of the chemoradiation therapy group (intervention), and 1,128 patients went on to receive treatment through the study.

In the control group, 543 patients were given chemoradiation with 28 radiation treatments over 5.5 weeks before a low anterior resection with total mesorectal excision. Chemoradiation comprised a drug combination called 5FUCRT, a combination of radiation therapy and a sensitizing fluoropyrimidine. In the intervention group, 585 patients received six cycles of modified FOLFOX6 followed by tumour restaging.

The primary endpoint was to determine disease-free survival. Secondary endpoints were local recurrence, overall survival, complete response, complete pathological resection, and toxic effects.

The study revealed the following findings:

  • At a median follow-up of 58 months, FOLFOX was noninferior to chemoradiotherapy for disease-free survival (hazard ratio for disease recurrence or death, 0.92).
  • Five-year disease-free survival was 80.8% in the FOLFOX group and 78.6% in the chemoradiotherapy group.
  • The groups were similar concerning overall survival (hazard ratio for death, 1.04) and local recurrence (hazard ratio, 1.18).
  • In the FOLFOX group, 9.1% received preoperative chemoradiotherapy, and 1.4% received postoperative chemoradiotherapy.

"Patients with locally advanced rectal cancer with tumours that respond to chemotherapy may safely forgo radiation therapy before surgery," the authors concluded.

Reference:

The study "Preoperative Treatment of Locally Advanced Rectal Cancer" was published in The New England Journal of Medicine.

DOI: 10.1056/NEJMoa2303269


The New England Journal of Medicinerectal cancerchemoradiotherapyfluorouracilleucovorinand oxaliplatinFOLFOXLocally Advanced Rectal Cancer
Source : The New England Journal of Medicine
Medha Baranwal
Medha Baranwal

    MSc. Biotechnology

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

    Show Full Article
    Next Story

    Editorial

    Featured image representing medico legal

    What's the Role of Expert Opinion in Medical Negligence?

    7- Point Discharge Protocol for AECOPD: Time to Inculcate in Practice

    7- Point Discharge Protocol for AECOPD: Time to Inculcate in Practice

    Aspirin Use in Women Aged 40-50 with Diabetes and Hypertension: Identifying the Ideal Candidates

    Aspirin Use in Women Aged 40-50 with Diabetes and Hypertension: Identifying the Ideal Candidates

    Darbapoetin Alfa In Chemotherapy Induced Anaemia: Check out 5 takeaways from recent study

    Darbapoetin Alfa In Chemotherapy Induced Anaemia: Check out 5 takeaways from recent study

    Biosimilar Denosumab of Alkem (Denuril) shows Comparable Efficacy in Treating Postmenopausal Osteoporosis in Indian Women

    Biosimilar Denosumab of Alkem (Denuril) shows Comparable Efficacy in Treating Postmenopausal...

    View All

    Journal Club Today

    Medical Journalism: Need of the Hour - Ft: Dr Prem Aggarwal (Chairman, Medical Dialogues), Dr Nandita Mohan (Head, MDTV Division, Medical Dialogues)

    Medical Journalism: Need of the Hour - Ft: Dr Prem Aggarwal (Chairman, Medical Dialogues), Dr...

    View All

    Health News Today

    Health Bulletin 08/ May/ 2025

    Health Bulletin 08/ May/ 2025

    View All
    © 2022 All Rights Reserved.
    Powered By: Hocalwire
    X
    We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok