Short-term radiotherapy plus chemotherapy versus long-term chemoradiotherapy in locally advanced rectal cancer (STELLAR): A planned interim analysis

Jin, Jianmin; Tang, Yanxiang; Liu, S.; Zhu, Yuan; Wang, W.; Li, G.; Wang, Xianding; Wang, J.; Yang, Jialin; Li, S.; Li, N.; Liu, W.; Li, Y.; Chi, Yuling; Zhou, Aiping; Huang, Jiaying; Jiang, Liming; Jiang, Jun; Zou, Sheng

doi:10.1093/annonc/mdy281.043

Cited by 12 publications

(10 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In total, 2,881 potential studies were included after removing 1,993 duplicates, 2,578 were excluded from title and abstract screening, 303 studies were considered eligible for full-text assessment, 289 full-text articles were excluded, 146 studies were excluded because they were not randomized control trials, 62 lacked relevant intervention or endpoints, 54 studies were excluded as they were reviews, and 12 studies were excluded because of no available results, and our efforts were unsuccessful in contacting the authors for further data. Eight RCTs met the inclusion criteria in this analysis [16][17][18][19][20][21][22][23][24][25][26][27][28][29]. All eight studies (n = 2,196 patients) were included in this final analysis (n = 1,113 treated with TNT and n = 1,083 treated with standard CRT).…”

Section: Characteristics Of the Selected Studiesmentioning

confidence: 99%

“…Our analysis included four phase II trials and four phase III trials. In most of the included studies, induction or consolidation (neoadjuvant) chemotherapy was multiagent oxaliplatin-based (n = 6) [17,18,20,25,26,29]. One study [24] used 5-fluorouracil plus folinic acid and another one used mFOLFIRINOX [30] (modify oxaliplatin, irinotecan, leucovorin, 5-fluorouracil).…”

Section: Characteristics Of the Selected Studiesmentioning

confidence: 99%

“…One study [24] used 5-fluorouracil plus folinic acid and another one used mFOLFIRINOX [30] (modify oxaliplatin, irinotecan, leucovorin, 5-fluorouracil). Three studies [17,18,30] used an induction treatment paradigm, and five studies [20,[24][25][26]29] explored the effects of consolidation treatment. In five studies [17,18,24,26,30], patients were treated with standard, long-course CRT ($50.4 Gy) in the experimental arm.…”

Section: Characteristics Of the Selected Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Total Neoadjuvant Therapy (TNT) versus Standard Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer: A Systematic Review and Meta-Analysis

et al. 2021

View full text Add to dashboard Cite

Background. Total neoadjuvant therapy (TNT) is a novel approach for locally advanced rectal cancer (LARC), which attempts to deliver both systemic chemotherapy and neoadjuvant chemoradiotherapy prior to surgery. However, its efficacy and safety remain controversial in randomized controlled trials (RCTs). We conducted this meta-analysis to assess such concerns. Materials and Methods. Head-to-head phase II/III RCTs were searched in Embase, PubMed, Web of Science, and the Cochrane Library, as well as other sources. The primary endpoint was pathologic complete response (pCR). Secondary endpoints were disease-free survival (DFS), overall survival (OS), local recurrence-free survival, distant metastasis-free survival, and the R0 resection rate.Results. Eight phase II/III RCTs involving 2,196 patients with LARC were assessed. The primary analysis demonstrated a statistically significant improvement in the pCR rate for TNT treatment (odds ratio, 1.77; 95% confidence interval [CI], 1.28-2.45; p = .0005). TNT treatment also showed improvements in DFS and OS outcomes compared with standard chemoradiotherapy (hazard ratio [HR], 0.83; 95% CI, 0.72-0.96; p = .03 and HR, 0.88; 95% CI, 0.74-1.05; p = .15). In addition, TNT treatment showed significant efficacy in reducing the risk of distant metastasis (HR, 0.81; 95% CI, 0.68-0.95; p = .012). Conclusion.The overall pCR rate may be improved with TNT compared with standard treatment. The TNT strategy may also improve DFS and OS and reduce the risk of distant metastasis. The Oncologist 2021;26:1-12 Implications for Practice: Locally advanced rectal cancer (LARC) is a relatively common disease, with a poor prognosis because of its high metastatic potential. The role of total neoadjuvant therapy (TNT) has always been controversial. This meta-analysis found that TNT in LARC is associated with a significant improvement in overall pathologic complete response rate, disease-free survival, overall survival, and distant metastasis-free survival compared with standard treatment. TNT is a promising strategy for LARC, especially for patients who have little desire for surgery.

show abstract

Section: Characteristics Of the Selected Studiesmentioning

confidence: 99%

Section: Characteristics Of the Selected Studiesmentioning

confidence: 99%

Section: Characteristics Of the Selected Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Total Neoadjuvant Therapy (TNT) versus Standard Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer: A Systematic Review and Meta-Analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Several randomized trials have provided insight into TNT, 35‐38 some of which have been recently reported in abstract form 3,4,6,39 . Overall, the data reflect superior treatment compliance of TNT compared with ACT, increased downstaging with higher pCR rates, and increased rates of rectal organ preservation.…”

Section: Medical Oncologist Perspective: Evolution Of Treatment Paradigms With Total Neoadjuvant Therapy (Induction Vs Consolidation Chemmentioning

confidence: 99%

Locally advanced rectal adenocarcinoma: Treatment sequences, intensification, and rectal organ preservation

Bigness

Imanirad

Şahin

et al. 2021

CA A Cancer J Clinicians

View full text Add to dashboard Cite

show abstract

“…These preliminary data were updated at the European Society for Medical Oncology 2018 Congress. A benefit continued to be exhibited in pathological complete response for the short-course RT group followed by CT which turned out to be 26.2% vs 5.3% for the group that received concomitant CRT[ 12 ].…”

Section: New Paradigmmentioning

confidence: 99%

New standard in locally advanced rectal cancer

Baeza¹,

Gabler²,

Couñago³

2020

WJCO

View full text Add to dashboard Cite

Short-term radiotherapy plus chemotherapy versus long-term chemoradiotherapy in locally advanced rectal cancer (STELLAR): A planned interim analysis

Cited by 12 publications

References 0 publications

Total Neoadjuvant Therapy (TNT) versus Standard Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer: A Systematic Review and Meta-Analysis

Total Neoadjuvant Therapy (TNT) versus Standard Neoadjuvant Chemoradiotherapy for Locally Advanced Rectal Cancer: A Systematic Review and Meta-Analysis

Locally advanced rectal adenocarcinoma: Treatment sequences, intensification, and rectal organ preservation

New standard in locally advanced rectal cancer

Contact Info

Product

Resources

About