Short-course radiotherapy followed by chemotherapy before total mesorectal excision (TME) versus preoperative chemoradiotherapy, TME, and optional adjuvant chemotherapy in locally advanced rectal cancer (RAPIDO): a randomised, open-label, phase 3 trial
RCT (n=912) found that radiotherapy followed by chemotherapy (CAPOX or FOLFOX4) then surgery was superior to standard of care of radiotherapy concomitant with capecitabine then surgery (treatment failure rate 23.7% vs 30.4%, HR 0.475, 95%CI 0.60-0.95).
Source:
The Lancet Oncology
SPS commentary:
A related commentary discusses this research concluding tha the landscape of total neoadjuvant therapy for locally advanced rectal cancers looks promising, and the RAPIDO protocol is likely to be the new standard of care, especially in resource-limited settings and the current climate of the COVID-19 pandemic, when fewer visits to health-care centres are desirable. This treatment protocol is also likely to increase the number of patients being offered organ preservation with the watch and wait policy due to the increase in pathological complete response and likely subsequent increase in clinical complete response rate.