Researchers from Italy have reported that neoadjuvant Xeloda® (capecitabine), Eloxatin® (oxaliplatin), and radiotherapy results in a high rate of complete and near complete responses in patients with Stage II-III rectal cancer. The details of this study appeared in the May 1, 2009 issue of Annals of Oncology.[1]
Surgery is the standard treatment for patients with locally advanced rectal cancer. There is also evidence that adjuvant therapy with radiation and/or chemotherapy improves survival and local control. More recently, neoadjuvant combined-modality therapy has been shown in Phase II and III studies to be superior to adjuvant therapy.
This phase II study included 46 patients with stage II-III rectal cancer who received neoadjuvant chemoradiotherapy. The pathological complete response rate was 21%, with 44% having a near complete response. There have been nine recurrences (20%). One was a local recurrence and eight were distant metastases with or without local recurrence. The main toxicity of this regimen was gastrointestinal with rare hematological toxicity. These authors suggest that this regimen is more effective than other regimens for the neoadjuvant treatment of Stage II-III rectal cancer.
Comments: A previous Swiss study showed similar results with a similar regimen of Xeloda, Eloxatin, and radiotherapy in patients with T3-T4 rectal cancer. Thus, it would appear that this is a well tolerated and effective neoadjuvant regimen.
Reference:
[1] Carlomagno C, Farella A, Bucci L, et al. Neo-adjuvant treatment of rectal cancer with capecitabine and oxaliplatin in combination with radiotherapy: a phase II study. Annals of Oncology 2009;20:906-912.
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