Expert Point of View: David Sebag-Montefiore, MD

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David Sebag-Montefiore, MD

David Sebag-Montefiore, MD, Professor of Clinical Oncology at the University of Leeds and St. James’s Institute of Oncology in the United Kingdom, was the invited discussant of the PROCTOR/SCRIPT study. He noted that in this 470-patient study, the disease-free and overall survival hazard ratios were less favorable than were observed in the Cochrane analysis of approximately 4,000 patients.

“The study lacks power, despite considerable effort. This was an extremely difficult trial to perform, and I congratulate the investigators for their perseverance,” he said.

Inconsistent Guidelines

“SCRIPT/PROCTOR findings do not change current practice, and they will reinforce existing views and guidelines,” he suggested, though he noted that various European guidelines are not completely consistent. The [European Society for Medical Oncology (ESMO)] guidelines say that adjuvant chemotherapy can be provided for stage III and high-risk stage II disease, while the [National Institute for Health and Care Excellence (NICE)] guidelines advise clinicians to consider it for these patients. The Dutch guidelines, on the other hand, state that there is no indication for adjuvant chemotherapy in rectal cancer.

The findings will, however, contribute to the ongoing current meta-analysis, he added, and will provide a valuable dataset for prognostic and predictive biomarker studies. ■

Disclosure: Dr. Sebag-Montefiore reported no potential conflicts of interest.

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