Systematic review and meta-analysis of the association between pathologic complete response and survival of rectal cancer patients

Pathologic complete response (pCR) to neoadjuvant therapy is increasingly used as a surrogate endpoint for survival in randomized clinical trials. A systematic review of 25 trials (11,882 patients) comparing neoadjuvant therapies in rectal cancer found no trial-level association between pCR and overall survival or disease-free survival. The authors conclude that these findings should be considered as a recommendation against using pCR as a surrogate endpoint for survival in rectal cancer.