Clinical Edge Journal Scan

Locally advanced rectal cancer: mFOLFOXIRI chemotherapy reduces the need for radiotherapy


 

Key clinical point: Neoadjuvant treatment with folinic acid, 5-fluorouracil, oxaliplatin, and irinotecan (mFOLFOXIRI) plus selective radiotherapy offers better disease-free survival (DFS) than neoadjuvant chemoradiotherapy (CRT; fluorouracil plus radiotherapy) in patients with locally advanced rectal cancer (LARC).

Major finding: Patients receiving mFOLFOXIRI without routine radiotherapy vs CRT had a significantly higher 3-year DFS rate (87.6% vs 75.8%; hazard ratio 0.46; P = .037).

Study details: This phase 2 study, FORTUNE, studied propensity score-matched patients with LARC who received neoadjuvant mFOLFOXIRI without routine radiotherapy (n = 73) with those who received neoadjuvant CRT in the phase 3 FOWARC study (n = 73).

Disclosures: This study was sponsored by the National Key Research and Development Program of China and Science and Technology Program of Guangzhou. The authors declared no conflicts of interest.

Source: Zhang J et al. Neoadjuvant mfolfoxiri with selective radiotherapy in locally advanced rectal cancer: Long-term outcomes of phase II study and propensity-score matched comparison with chemoradiotherapy. Dis Colon Rectum. 2022 (Jul 12). Doi: 10.1097/DCR.0000000000002424

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