Wolfgang Eisterer1, Alexander De Vries2, Dietmar Öfner3, Hans Rabl4, Renate Koplmüller5, Richard Greil6, Jöerg Tschmelitsch7, Rainer Schmid8, Karin Kapp9, Peter Lukas10, Felix Sedlmayer11, Gerald Höfler12, Michael Gnant13, Josef Thaler5. 1. Department of Internal Medicine V, Medical University, Innsbruck, Austria wolfgang.eisterer@i-med.ac.at. 2. Department of Radiotherapy and Radio-oncology, Feldkirch Hospital, Feldkirch, Austria. 3. Department of Surgery, Paracelsus Medical University, Salzburg, Austria. 4. Department of Surgery, Leoben Hospital, Leoben, Austria. 5. Department of Internal Medicine IV, Hospital Wels-Grieskirchen, Wels, Austria. 6. Department of Internal Medicine III, Paracelsus Medical University, Salzburg, Austria. 7. Department of Surgery, St. Veit Hospital, Sankt Veit an de Glan, Austria. 8. Department of Radio-oncology, Medical University of Vienna, Vienna, Austria. 9. Department of Radio-oncology, Medical University, Graz, Austria. 10. Department of Radio-oncology, Medical University, Innsbruck, Austria. 11. Department of Radio-oncology, Paracelsus Medical University, Salzburg, Austria. 12. Department of Pathology, Medical University, Graz, Austria. 13. Department of Surgery, Medical University of Vienna, Vienna, Austria Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Abstract
BACKGROUND/AIM: To investigate the feasibility and safety of preoperative capecitabine, cetuximab and radiation in patients with MRI-defined locally advanced rectal cancer (LARC, cT3/T4). PATIENTS AND METHODS: 31 patients with LARC were treated with cetuximab and capecitabine concomitantly with 45 Gy radiotherapy and resected by total mesorectal excision. Histopathological response and association with KRAS status was evaluated. RESULTS: R0-resection was possible in 27 of 31 (86%) patients. No complete pathological remission was observed. Radiochemotherapy with capecitabine and cetuximab was safe to administer and diarrhea was the main toxicity. KRAS-status did not correlate to down-staging or pathological response concerning T- or N-stage. CONCLUSION: Neoadjuvant therapy with capecitabine and cetuximab in combination with radiotherapy did not lead to complete pathological remission. Treatment tolerability was excellent and toxicity remained low. KRAS status did not influence treatment outcomes. Capecitabine in combination with radiotherapy remains a standard therapy for locally advanced rectal cancer. Copyright
BACKGROUND/AIM: To investigate the feasibility and safety of preoperative capecitabine, cetuximab and radiation in patients with MRI-defined locally advanced rectal cancer (LARC, cT3/T4). PATIENTS AND METHODS: 31 patients with LARC were treated with cetuximab and capecitabine concomitantly with 45 Gy radiotherapy and resected by total mesorectal excision. Histopathological response and association with KRAS status was evaluated. RESULTS: R0-resection was possible in 27 of 31 (86%) patients. No complete pathological remission was observed. Radiochemotherapy with capecitabine and cetuximab was safe to administer and diarrhea was the main toxicity. KRAS-status did not correlate to down-staging or pathological response concerning T- or N-stage. CONCLUSION: Neoadjuvant therapy with capecitabine and cetuximab in combination with radiotherapy did not lead to complete pathological remission. Treatment tolerability was excellent and toxicity remained low. KRAS status did not influence treatment outcomes. Capecitabine in combination with radiotherapy remains a standard therapy for locally advanced rectal cancer. Copyright
Authors: Cynthia Gail Leichman; Shannon L McDonough; Stephen R Smalley; Kevin G Billingsley; Heinz-Josef Lenz; Matthew A Beldner; Aram F Hezel; Mario R Velasco; Katherine A Guthrie; Charles D Blanke; Howard S Hochster Journal: Clin Colorectal Cancer Date: 2017-10-24 Impact factor: 4.481