- Rectal resection after neoadjuvant chemotherapy (NACT) with modified FOLFOX (leucovorin, 5-fluorouracil, and oxaliplatin; mFOLFOX6) can be performed safely in patients with locally advanced rectal cancer (LARC), and is associated with an acceptable incidence of postoperative complications.
Why this matters
- FOLFOX in combination with a fluorinated pyrimidine has demonstrated efficacy as postoperative adjuvant therapy for colon cancer.
- Multicenter prospective R-NAC-01 study to investigate the safety of rectal surgery after 4 courses of 2-week mFOLFOX6 in 41 patients (36 men, 5 women) with locally advanced rectal cancer.
- Mean patient age, 60.8 years.
- BMI, 23.1 kg/m2.
- Prescribed surgical procedure was total mesorectal resection; D3 surgery involved high ligation of the inferior mesenteric artery and lateral lymph node dissection.
- Funding: None disclosed.
- In 38 patients who completed therapy per protocol, 10.5% experienced grade ≥3 postoperative complications including anastomotic leakage (7.1%).
- No patients achieved pathological complete response; 41.5% achieved clinical downstaging; N grade was downstaged in 53.7% of patients.
- 7.3% of patients experienced grade 2 NACT-related adverse events; 1 patient experienced grade 3 nausea, 1 experienced grade 4 infusion port infection.
- Limited sample size.