Thierry Conroy, MD, on Rectal Cancer: Long-Term Results on mFOLFIRINOX vs Preoperative Chemoradiation Therapy
2023 ASCO Annual Meeting
Thierry Conroy, MD, of the Institut de Cancérologie de Lorraine, discusses phase III findings from the PRODIGE 23 trial, showing that neoadjuvant chemotherapy with mFOLFIRINOX followed by chemoradiotherapy, surgery, and adjuvant chemotherapy improved all outcomes, including overall survival, in patients with locally advanced rectal cancer compared with standard chemoradiotherapy, surgery, and adjuvant chemotherapy (Abstract LBA3504).
Transcript
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Prodige 23 is a phase three randomized trial that we perform in France in 35 centers. And we have presented the seven-year result of that study. And we confirm all the benefit we had in this study, and we already published. It was a comparison between the standard of care preoperative chemoradiation ventium surgery and six month of adjuvant chemotherapy in patients with locally advanced rectal cancer. And we compare it to three month of induction chemotherapy using the modify Folfirinox regimen than preoperative chemo radiation TME and three month of adjuvant chemotherapy. All patients receive six month of chemotherapy.
We have now a follow-up of 82 month. It means quite seven year, and we confirm a very important reduction of metastases as from 10%. We have still a benefit in the primary endpoint, which is DFS. Also benefiting cancer specific survival. One important point is that we had no increase in local relapse in the experimental arm, which is lower than 5%. And the other point is that the survival at metastatic disease was exactly the same in the two arms, and it was not reduced in the experimental arm.
We had an overall survival benefit, and this is the major point of this study, as we had the 7% overall survival benefit when quality of life improve faster and higher levels in the experimental alarm. To conclude, this is the very positive trial and very good news for patients. The next step will be to know if with induction chemotherapy with Folfirinox some patients may not receive chemo chemo radiation, especially in case of good response to induction chemotherapy. The other point is to know if induction chemotherapy will increase the rate of organ preservation.
The ASCO Post Staff
Bradley J. Monk, MD, of the University of Arizona, Phoenix, and Creighton University, discusses phase III findings from the KEYNOTE-826 study of overall survival results in patients with persistent, recurrent, or metastatic cervical cancer. Study participants received first-line treatment of pembrolizumab plus chemotherapy, with or without bevacizumab, which reduced the risk of death by up to 40% in three different subsets of patients (Abstract 5500).
The ASCO Post Staff
Arlene O. Siefker-Radtke, MD, of The University of Texas MD Anderson Cancer Center, discusses the combination of erdafitinib and cetrelimab, which demonstrated clinically meaningful activity and was well tolerated in cisplatin-ineligible patients with metastatic urothelial carcinoma and fibroblast growth factor receptor alterations (Abstract 4504).
The ASCO Post Staff
Marie Plante, MD, of Canada’s Université Laval and the CHUQ Hotel Dieu de Québec, discusses phase III results from a study that compared radical hysterectomy and pelvic node dissection vs simple hysterectomy and pelvic node dissection in patients with low-risk early-stage cervical cancer. The pelvic recurrence rate at 3 years in the women who underwent simple hysterectomy is not inferior to those who had radical hysterectomy. In addition, fewer surgical complications and better quality of life were observed with simple hysterectomy (LBA5511).
The ASCO Post Staff
James Chih-Hsin Yang, MD, PhD, of the National Taiwan University Hospital and National Taiwan University Cancer Center, discusses the latest data from the phase III KEYNOTE-789 study, which evaluated the efficacy and safety of pemetrexed plus platinum chemotherapy (carboplatin or cisplatin) with or without pembrolizumab in the treatment of adults with EGFR tyrosine kinase inhibitor–resistant, EGFR–mutated, metastatic nonsquamous non–small cell lung cancer (NSCLC) (Abstract LBA9000).
The ASCO Post Staff
Shailender Bhatia, MD, of the University of Washington and Fred Hutchinson Cancer Center, discusses phase I/II results on the efficacy of nivolumab with or without ipilimumab in patients with recurrent or metastatic Merkel cell carcinoma. The study found that, for this rare and aggressive skin cancer, nivolumab showed clinical activity in advanced disease. However, these results from CheckMate 358 do not suggest an additional benefit with ipilimumab added to nivolumab (Abstract 9506).