Fase 2 study of organ preservation with total neoadjuvant therapy for locally advanced rectal adenocarcinoma

A multicenter randomized phase 2 study in the USA found that with total neoadjuvant therapy organ preservation was achievable in half of the patients with locally advanced rectal adenocarcinoma, without detriment in survival compared with historical controls treated with chemoradiotherapy, total mesorectal excision, and postoperative chemotherapy. The order of chemoradiation and systemic chemotherapy did not affect disease-free survival, but chemoradiation followed by consolidation chemotherapy was associated with a higher rate of organ preservation compared with induction chemotherapy followed by chemoradiotherapy.