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Related Concept Videos

Targeted Cancer Therapies02:57

Targeted Cancer Therapies

The targeted cancer therapies, also known as “molecular targeted therapies,” take advantage of the molecular and genetic differences between the cancer cells and the normal cells. It needs a thorough understanding of the cancer cells to develop drugs that can target specific molecular aspects that drive the growth, progression, and spread of cancer cells without affecting the growth and survival of other normal cells in the body.
There are several types of targeted therapies against specific...

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Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer.

Alessandro Audisio1,2, Chiara Gallio1, Vaneja Velenik3

  • 1Université libre de Bruxelles, Hôpital Universitaire de Bruxelles, Institut Jules Bordet-Hôpital Erasme, Brussels, Belgium.

JAMA Oncology
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Summary

Total neoadjuvant therapy (TNT) for rectal cancer shows varied regimens in practice but aligns with trial efficacy. This study suggests TNT is effective in a clinical setting, regardless of the specific treatment plan used.

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Area of Science:

  • Oncology
  • Clinical Research
  • Gastrointestinal Oncology

Background:

  • Rectal cancer treatment has evolved with the introduction of total neoadjuvant therapy (TNT).
  • TNT involves delivering chemotherapy and radiotherapy before surgery or a watch-and-wait approach.
  • Assessing TNT's real-world application and outcomes is crucial for optimizing patient care.

Purpose of the Study:

  • To evaluate the utilization and clinical outcomes of total neoadjuvant therapy (TNT) in routine practice for rectal cancer.
  • To compare the efficacy and safety of different TNT regimens in a large, international cohort.

Main Methods:

  • An international, multicenter study included 1585 patients with stage II/III rectal adenocarcinoma treated with TNT.
  • Patients received various TNT regimens, including PRODIGE 23-like, RAPIDO-like, and OPRA-like protocols.
  • Outcomes assessed included treatment adherence, safety, pathological response, and survival (event-free and overall survival).

Main Results:

  • Significant variation in TNT regimen choice was observed across 61 centers in 21 countries.
  • Pathological or clinical complete response rates reached 23.2%, with 3-year event-free survival at 68% and 5-year overall survival at 79%.
  • While PRODIGE 23-like regimens showed trends toward better survival in the overall population, no significant differences were found between regimens in the matched cohort.

Conclusions:

  • Total neoadjuvant therapy (TNT) is utilized with considerable regimen diversity in clinical practice.
  • The study findings support the overall efficacy of TNT for rectal cancer, consistent with clinical trial results.
  • Real-world data suggest TNT is a viable and effective treatment strategy, irrespective of the specific regimen employed.