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eo-adjuvant FOLFOXIRI and chemoradiotherapy for high risk (ugly”) locally advanced rectal cancer.

Recruiting
Conditions
ocally advanced rectal cancer
Registration Number
NL-OMON28766
Lead Sponsor
Catharina Hospital Eindhoven
Brief Summary

/A

Detailed Description

Not available

Recruitment & Eligibility

Status
Recruiting
Sex
Not specified
Target Recruitment
128
Inclusion Criteria

? 18 years or older
? WHO performance score 0-1.
? Fit for (modified dose) triple chemotherapy (FOLFOXIRI)
? Histopathologically confirmed rectal cancer.
? Lower border of the tumour located below the sigmoidal take-off as established on MRI of the pelvis.
? Confirmed high-risk locally advanced rectal cancer, meeting one of the following imaging based criteria:
o Tumour invasion of mesorectal fascia (MRF+)
o The presence of grade 4 extramural venous invasion (mrEMVI)
o The presence of tumour deposits (TD)
o The presence of extramesorectal lymph nodes with a short-axis size = 7mm (LNN)
? Resectable disease as determined on magnetic resonance imaging (MRI) or deemed resectable disease after neoadjuvant treatment.
Expected gross incomplete resection with overt tumour remaining in the patient after resection, tumour invasion in the neuroforamina, encasement of the ischiadic nerve and invasion of the cortex from S3 and upwards are considered not resectable
? Written informed consent.

Exclusion Criteria

? Evidence of metastatic disease at time of inclusion or within six months prior to inclusion except for patients with enlarged iliac or inguinal lymph nodes and aspecific lung noduli.
? Homozygous DPD deficiency.
? Any chemotherapy within the past 6 months.
o Any contraindication for the planned systemic therapy (e.g. severe allergy, pregnancy, kidney dysfunction and thrombocytopenia), as determined by the medical oncologist.
? Radiotherapy in the pelvic area within the past 6 months.
? Any contraindication for the planned chemoradiotherapy (e.g. severe allergy to the chemotherapy agent or no possibility to receive radiotherapy), as determined by the medical oncologist and/or radiation oncologist. Any contraindication to undergo surgery, as determined by the surgeon and/or anaesthesiologist.
? Concurrent malignancies that interfere with the planned study treatment or the prognosis of the resected tumour.

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
The main study parameter is the proportion of patients with a pathological complete response (pCR) and those patients who started a wait and see strategy and have sustained clinical complete response (cCR) at 1 year.
Secondary Outcome Measures
NameTimeMethod
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