Rectal cancer - null regimens
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The purpose of this page is to provide references to "null therapy" such as placebo and observation. These references provide further insight into the historical development of the treatment landscape. See the main rectal cancer page for regimens that include active anticancer treatment.
Neoadjuvant therapy
No neoadjuvant therapy
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Oates et al. 1996 | 1981-1989 | Phase 3 (C) | RT | Seems to have inferior DFS |
Cedermark et al. 1997 (Swedish Rectal Cancer Trial) | 1987-1990 | Phase 3 (C) | RT | Inferior OS |
Kapiteijn et al. 2001 | 1996-1999 | Phase 3 (C) | RT | Inferior local recurrence rate |
No neoadjuvant therapy.
References
- Oates GD, Stenning SP, Hardcastle JD; Medical Research Council Rectal Cancer Working Party. Randomised trial of surgery alone versus radiotherapy followed by surgery for potentially operable locally advanced rectal cancer. Lancet. 1996 Dec 14;348(9042):1605-10. link to original article PubMed
- Swedish Rectal Cancer Trial: Cedermark B, Dahlberg M, Glimelius B, Påhlman L, Rutqvist LE, Wilking N; Swedish Rectal Cancer Trial investigators. Improved survival with preoperative radiotherapy in resectable rectal cancer. N Engl J Med. 1997 Apr 3;336(14):980-7. Erratum in: N Engl J Med 1997 May 22;336(21):1539. link to original article PubMed
- Update: Folkesson J, Birgisson H, Pahlman L, Cedermark B, Glimelius B, Gunnarsson U. Swedish Rectal Cancer Trial: long lasting benefits from radiotherapy on survival and local recurrence rate. J Clin Oncol. 2005 Aug 20;23(24):5644-50. link to original article PubMed
- Kapiteijn E, Marijnen CA, Nagtegaal ID, Putter H, Steup WH, Wiggers T, Rutten HJ, Pahlman L, Glimelius B, van Krieken JH, Leer JW, van de Velde CJ; Dutch Colorectal Cancer Group. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med. 2001 Aug 30;345(9):638-46. link to original article PubMed
Adjuvant therapy
Observation
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Mittelman et al. 1985 | 1975-1980 | Phase 3 (C) | 1. 5-FU & Semustine | Not reported |
2. 5-FU, Semustine, RT | Inferior RFS | |||
3. RT | Not reported | |||
Fisher et al. 1988 (NSABP R-01) | 1977-1986 | Phase 3 (C) | 1. MOF | Not reported |
2. RT | Did not meet efficacy endpoints of DFS/OS | |||
Amott et al. 1996 | 1984-1989 | Phase 3 (C) | RT | Inferior local recurrence rate |
Sainato et al. 2014 (I-CNR-RT) | 1992-2001 | Phase 3 (C) | FULV | Did not meet primary endpoint of OS |
Hamaguchi et al. 2010 (NSAS-CC) | 1996-2001 | Phase 3 (C) | UFT | Seems to have inferior OS |
Breugom et al. 2014 (PROCTOR) | 2000-2013 | Phase 3 (C) | FULV | Did not meet primary endpoint of OS |
Breugom et al. 2014 (SCRIPT) | 2000-2013 | Phase 3 (C) | Capecitabine | Did not meet primary endpoint of OS |
Glynne-Jones et al. 2014 (Chronicle) | 2004-2008 | Phase 3 (C) | XELOX | Did not meet primary endpoint of DFS |
Okuno et al. 2017 (JFMC38) | 2011-2013 | Phase 3 (C) | UFT & PSK | Did not meet primary endpoint of DFS |
No further treatment after (neoadjuvant therapy) and surgery.
Preceding treatment
- Mittelman et al. 1985 & JFMC38: Surgery
- Chronicle: 5-FU-based chemoradiotherapy, then surgery
- I-CNR-RT: FULV & RT, then surgery
- PROCTOR & SCRIPT: 5-FU-based chemoradiotherapy or RT, then surgery
References
- Mittelman A, Holyoke ED, Stablein DM, Novak JW, Thomas PRM, Moertel CG, Weiland LH, Livstone EM, Bruckner HW, Knowlton AH; Gastrointestinal Tumor Study Group. Prolongation of the disease-free interval in surgically treated rectal carcinoma. N Engl J Med. 1985 Jun 6;312(23):1465-72. link to original article PubMed
- NSABP R-01: Fisher B, Wolmark N, Rockette H, Redmond C, Deutsch M, Wickerham DL, Fisher ER, Caplan R, Jones J, Lerner H, Gordon P, Feldman M, Cruz A, Legault-Poisson S, Wexler M, Lawrence W, Robidoux A. Postoperative adjuvant chemotherapy or radiation therapy for rectal cancer: results from NSABP protocol R-01. J Natl Cancer Inst. 1988 Mar 2;80(1):21-9. link to original article PubMed
- Amott SJ, Stenning SP, Hardcastle JD; Medical Research Council Rectal Cancer Working Party. Randomised trial of surgery alone versus surgery followed by radiotherapy for mobile cancer of the rectum. Lancet. 1996 Dec 14;348(9042):1610-4. link to original article PubMed
- NSAS-CC: Hamaguchi T, Shirao K, Moriya Y, Yoshida S, Kodaira S, Ohashi Y; NSAS-CC Group. Final results of randomized trials by the National Surgical Adjuvant Study of Colorectal Cancer (NSAS-CC). Cancer Chemother Pharmacol. 2011 Mar;67(3):587-96. Epub 2010 May 19. link to original article PubMed NCT00152230
- Chronicle: Glynne-Jones R, Counsell N, Quirke P, Mortensen N, Maraveyas A, Meadows HM, Ledermann J, Sebag-Montefiore D. Chronicle: results of a randomised phase III trial in locally advanced rectal cancer after neoadjuvant chemoradiation randomising postoperative adjuvant capecitabine plus oxaliplatin (XELOX) versus control. Ann Oncol. 2014 Jul;25(7):1356-62. Epub 2014 Apr 8. link to original article PubMed NCT00427713
- I-CNR-RT: Sainato A, Cernusco Luna Nunzia V, Valentini V, De Paoli A, Maurizi ER, Lupattelli M, Aristei C, Vidali C, Conti M, Galardi A, Ponticelli P, Friso ML, Iannone T, Osti FM, Manfredi B, Coppola M, Orlandini C, Cionini L. No benefit of adjuvant Fluorouracil Leucovorin chemotherapy after neoadjuvant chemoradiotherapy in locally advanced cancer of the rectum (LARC): Long term results of a randomized trial (I-CNR-RT). Radiother Oncol. 2014 Nov;113(2):223-9. Epub 2014 Nov 14. link to original article PubMed
- PROCTOR/SCRIPT: Breugom AJ, van Gijn W, Muller EW, Berglund Å, van den Broek CB, Fokstuen T, Gelderblom H, Kapiteijn E, Leer JW, Marijnen CA, Martijn H, Meershoek-Klein Kranenbarg E, Nagtegaal ID, Påhlman L, Punt CJ, Putter H, Roodvoets AG, Rutten HJ, Steup WH, Glimelius B, van de Velde CJ; Dutch Colorectal Cancer Group; Nordic Gastrointestinal Tumour Adjuvant Therapy Group. Adjuvant chemotherapy for rectal cancer patients treated with preoperative (chemo)radiotherapy and total mesorectal excision: a Dutch Colorectal Cancer Group (DCCG) randomized phase III trial. Ann Oncol. 2015 Apr;26(4):696-701. Epub 2014 Dec 5. link to original article PubMed ISRCTN36266738
- JFMC38: Okuno K, Aoyama T, Oba K, Yokoyama N, Matsuhashi N, Kunieda K, Nishimura Y, Akamatsu H, Kobatake T, Morita S, Yoshikawa T, Sakamoto J, Saji S. Randomized phase III trial comparing surgery alone to UFT + PSK for stage II rectal cancer (JFMC38 trial). Cancer Chemother Pharmacol. 2018 Jan;81(1):65-71. Epub 2017 Nov 1. link to original article link to PMC article PubMed