Thierry Conroy, MD, on Rectal Cancer: Long-Term Results on mFOLFIRINOX vs Preoperative Chemoradiation Therapy

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.