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
Disclaimer: This video transcript has not been proofread or edited and may contain errors.
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.
Related Videos
The ASCO Post Staff
Alberto Bossi, MD, of Institut Gustave Roussy, discusses phase III findings showing that combining prostate radiotherapy with systemic treatment did not improve overall survival in men with de novo metastatic castration-sensitive prostate cancer and low metastatic burden. However, best outcomes (radiographic progression–free-survival and overall survival) were observed in men receiving the standard of care plus abiraterone acetate plus prednisone with radiotherapy (Abstract LBA5000).
The ASCO Post Staff
Enrique Grande, MD, of The University of Texas MD Anderson Cancer Center, discusses new findings that show initial responses to induction therapy with atezolizumab plus platinum and gemcitabine did not seem to impact overall survival for patients with metastatic urothelial carcinoma. Cisplatin-treated patients appeared to derive a greater benefit with atezolizumab than did carboplatin-treated patients (Abstract 4503).
The ASCO Post Staff
Narjust Florez, MD, of Dana-Farber Cancer Institute, and Filippo Gustavo Dall’Olio, MD, of Institut Gustave Roussy, discuss circulating tumor DNA tumor fraction, and its link to survival in patients with advanced non–small cell lung cancer (NSCLC) treated with maintenance durvalumab in the UNICANCER SAFIR02-Lung/IFCT1301 trial. Tumor fraction was positive in 16% of patients randomly assigned to receive durvalumab in the study. This population seems to have a limited benefit from maintenance durvalumab after induction chemotherapy (Abstract 2516).
The ASCO Post Staff
Narjust Florez, MD, of Dana-Farber Cancer Institute, and Ferdinandos Skoulidis, MD, PhD, of The University of Texas MD Anderson Cancer Center, discuss results of a biomarker subgroup analysis, showing that sotorasib demonstrated consistent clinical benefit vs docetaxel in all molecularly defined subgroups of patients with pretreated KRAS G12C–mutated advanced non–small cell lung cancer (NSCLC). Although no predictive biomarkers were confirmed, novel hypothesis-generating signals were observed (Abstract 9008).
The ASCO Post Staff
Bobbie J. Rimel, MD, of Cedars-Sinai Medical Center, and Mansoor R. Mirza, MD, of Denmark’s Rigshospitalet and Copenhagen University Hospital, discuss new findings on dostarlimab-gxly plus carboplatin/paclitaxel, which improved progression-free survival while maintaining health-related quality of life, further supporting its use as a standard of care in primary advanced or recurrent endometrial cancer (Abstract 5504).
