Total Neoadjuvant Therapy in Rectal Cancer Increases Pathologic Complete Response

Preoperative chemoradiotherapy, total mesorectal excision, and adjuvant chemotherapy are standard treatments for locally advanced rectal cancer. There is increasing interest in total neoadjuvant therapy to potentially enhance therapy delivery, allow nonoperative management and organ preservation in responding patients, and improve survival.

Investigators report results of UNICANCER-PRODIGE 23, an open-label, multicenter, randomized phase III trial comparing conventional treatment (preoperative capecitabine/radiotherapy, surgery, and 6 months of adjuvant chemotherapy [FOLFOX or capecitabine]) with neoadjuvant therapy consisting of 3 months of FOLFIRINOX (oxaliplatin, irinotecan, leucovorin, and infusional fluorouracil) followed by capecitabin…