{"id":580708,"date":"2026-08-10T20:22:10","date_gmt":"2026-08-10T20:22:10","guid":{"rendered":"https:\/\/www.newsbeep.com\/il\/580708\/"},"modified":"2026-08-10T20:22:10","modified_gmt":"2026-08-10T20:22:10","slug":"phase-iii-trial-supports-intensified-total-neoadjuvant-therapy-in-high-risk-rectal-cancer","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/il\/580708\/","title":{"rendered":"Phase III Trial Supports Intensified Total Neoadjuvant Therapy in High-Risk Rectal Cancer"},"content":{"rendered":"

\n \t\t By Wendy LaGrego<\/a>

Posted: 8\/10\/2026 10:30:00 AM
\n\t\t
Last Updated: 8\/10\/2026 1:15:57 PM<\/p>\n

In a multicenter Chinese randomized phase III trial published in the Journal of Clinical Oncology<\/a>, Wang et al found that an intensified total neoadjuvant therapy approach integrating long-course radiotherapy with uninterrupted capecitabine and oxaliplatin chemotherapy improved disease-free survival compared with conventional neoadjuvant chemoradiotherapy in patients with high-risk locally advanced rectal cancer.<\/p>\n

Study Details<\/p>\n

The multicenter, open-label trial enrolled 458 patients between June 2017 and December 2023. Study participants had stage II or III rectal adenocarcinoma and at least one MRI-defined high-risk feature (47.82% of patients had cT4 disease, 75.98% cN2 disease, 70.96% threatened mesorectal fascia, and 54.80% extramural venous invasion).<\/p>\n

Patients were randomly assigned 1:1 at nine Chinese institutions to receive either total neoadjuvant therapy integrating long-course radiotherapy with induction, concurrent, and consolidation capecitabine and oxaliplatin (doublet-LC TNT; 232 patients) (experimental regimen) or conventional neoadjuvant chemoradiotherapy with capecitabine and long-course radiotherapy followed by surgery and adjuvant chemotherapy (nCRT; 226 patients) (control group). The primary endpoint was disease-free survival.<\/p>\n

Key Results<\/p>\n

At a median follow-up of 51 months, 3-year disease-free survival was 74.8% with doublet-LC TNT compared with 66.0% for conventional neoadjuvant chemoradiotherapy (hazard ratio [HR] = 0.674, 95% confidence interval [CI] = 0.489\u20130.929, P = .016). Three-year metastasis-free survival also favored the experimental arm (77.7% vs 67.6%, HR = 0.655, 95% CI = 0.469\u20130.915, P = .013). Overall survival at 3 years was numerically higher with doublet-LC TNT (90.2% vs 87.5%, HR = 0.727, P = .167), and locoregional failure was similar between groups (6.03% vs 6.19%).<\/p>\n

The experimental regimen also produced greater tumor regression. Among patients who underwent surgery, the pathologic complete response rate was 26.37% with doublet-LC TNT compared with 9.80% with neoadjuvant chemoradiotherapy (P < .001). Favorable tumor regression (TRG 0\u20131) occurred in 49.25% vs 28.92% of patients, and ypN0 status was achieved in 81.09% vs 69.12%, respectively.<\/p>\n

Grade \u2265 3 adverse events during neoadjuvant therapy were more frequent with doublet-LC TNT (27.59% vs 8.56%), but the incidence of severe adverse events across the entire treatment course was comparable (28.02% vs 24.32%), as were major postoperative complications. Thrombocytopenia was the most common grade \u2265 3 adverse event during neoadjuvant doublet-LC TNT and during adjuvant chemotherapy in the nCRT group.<\/p>\n

The investigators noted that longer follow-up is needed to assess long-term outcomes and that the conventional neoadjuvant chemoradiotherapy control arm, given the trial\u2019s long accrual period, reflects an earlier treatment paradigm than current practice.<\/p>\n

The investigators concluded: \u201cCompared with conventional [neoadjuvant chemoradiotherapy], doublet-LC TNT improved [disease-free survival], [metastasis-free survival], and [pathologic complete response] rates with manageable toxicity. These findings support this intensified, doublet-based regimen as a standard option within the modern total neoadjuvant therapy paradigm. Further comparative studies are warranted to evaluate these results against other short-course radiotherapy\u2011based or non-doublet-concurrent TNT regimens.\u201d<\/p>\n

Ziqiang Wang, MD, PhD, of Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China, is the corresponding author for the Journal of Clinical Oncology article.<\/p>\n

DISCLOSURE: The study was supported by Sichuan Science and Technology Support Project. For full disclosures of the study authors, visit ascopubs.org<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"By Wendy LaGregoPosted: 8\/10\/2026 10:30:00 AM Last Updated: 8\/10\/2026 1:15:57 PM In a multicenter Chinese randomized phase III…\n","protected":false},"author":2,"featured_media":580709,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[114,85,46],"class_list":["post-580708","post","type-post","status-publish","format-standard","has-post-thumbnail","category-business","tag-business","tag-il","tag-israel"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/580708","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=580708"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/580708\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/580709"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=580708"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=580708"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=580708"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}