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
Narjust Florez, MD, of Dana-Farber Cancer Institute, and Ticiana Leal, MD, of Winship Cancer Institute of Emory University, discuss the use of tumor treating fields therapy, in which electric fields disrupt processes critical for cancer cell viability. Already approved by the FDA to treat glioblastoma and mesothelioma, the treatment has extended overall survival in this phase III study of patients with metastatic non–small cell lung cancer (NSCLC) with progression on or after platinum-based chemotherapy, without exacerbating systemic toxicities (Abstract LBA9005).
The ASCO Post Staff
Arlene O. Siefker-Radtke, MD, of The University of Texas MD Anderson Cancer Center, discusses phase III findings showing that for patients with advanced or metastatic urothelial carcinoma and FGFR alteration who already had been treated with a PD-(L)1 inhibitor, erdafitinib significantly improved overall and progression-free survival, as well as overall response rate, compared with investigator’s choice of chemotherapy (LBA4619).
The ASCO Post Staff
Shilpa Gupta, MD, of Cleveland Clinic, discusses the results from the EV-103 study and the unmet need for effective first-line therapies in cisplatin-ineligible patients with locally advanced or metastatic urothelial carcinoma. After nearly 4 years of follow-up, the trial findings showed that enfortumab vedotin-ejfv plus pembrolizumab continues to demonstrate promising survival trends with rapid and durable responses in this population (Abstract 4505).
The ASCO Post Staff
Alicia K. Morgans, MD, MPH, of Dana-Farber Cancer Institute, and Karim Fizazi, MD, of Institut Gustave Roussy, University of Paris-Saclay, discuss findings from the TALAPRO-2 study, which showed that talazoparib plus enzalutamide improved radiographic progression–free survival over standard-of-care enzalutamide as first-line treatment for patients with metastatic castration-resistant prostate cancer and HRR gene alterations. This regimen also delayed the time to deterioration in global health status and quality of life (Abstract 5004).
The ASCO Post Staff
Nirav N. Shah, MD, of the Medical College of Wisconsin, discusses the efficacy and safety of pirtobrutinib, a highly selective, noncovalent BTK inhibitor, studied for more than 3 years in the BRUIN trial. The results showed that the use of pirtobrutinib continues to have durable efficacy and a favorable safety profile in heavily pretreated patients with relapsed or refractory mantle cell lymphoma and prior BTK inhibitor therapy. Responses were observed in patients with high-risk disease features, including blastoid/pleomorphic variants, elevated Ki67 index, and TP53 mutations (Abstract 7514).
