Trial reportEuropean journal of cancer (Oxford, England : 1990)2024
Chemoradiotherapy plus induction or consolidation chemotherapy as total neoadjuvant therapy for locally advanced rectal cancer: Pooled analysis of the CAO/ARO/AIO-12 and the OPRA randomized phase 2 trials.
Trial report in European journal of cancer (Oxford, England : 1990), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- SEOM-GEMCAD-TTD clinical guidelines for localized rectal cancer (2025).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Guideline
- Watch-and-Wait strategy for locally advanced rectal cancer after neoadjuvant chemoradiotherapy: a comprehensive review.Frontiers in oncology · 2026Pooled it
- Trial
- Four-Year Survival Outcomes of Personalized Total Neoadjuvant Therapy Versus Chemotherapy During the 'Wait Period' Versus Standard Chemoradiotherapy for Locally Advanced Rectal Cancer.Journal of gastrointestinal cancer · 2026Article
- Watch-and-wait in rectal cancer: A critical appraisal of promise, perils and unresolved contours of organ preservation (Review).Oncology letters · 2026Review
- [Anorectal functional disorders following organ-preserving treatment and resection of rectal cancer].Chirurgie (Heidelberg, Germany) · 2026Review
- Article
- A new perspective on radiotherapy in the comprehensive treatment of cancer.Precision radiation oncology · 2026Review
- Safety and Tolerability of Different Total Neoadjuvant Therapies in Patients With Locally Advanced Rectal Cancer.Cancer medicine · 2026Article
- Significant Correlation of Dynamic Pan-Immune Inflammation Value and Magnetic Resonance Imaging Response in Patients with Locally Advanced Rectal Cancer Treated with Total Neoadjuvant Therapy.Current oncology (Toronto, Ont.) · 2026Article
- Discrepancies between clinical and radiological assessment of complete remission of rectal cancer after neoadjuvant radiochemotherapy.Langenbeck's archives of surgery · 2026Article
- Significance of nodal yield after rectal resection in the TNT era: does count matter?BMC cancer · 2026Article
- MRI-defined high-risk rectal cancer patients: comparison of treatment response and survival outcomes between total neoadjuvant therapy and neoadjuvant chemoradiotherapy-a propensity score matched analysis.International journal of colorectal disease · 2025Observational
- Article
- Controversies and Perspectives in the Current Management of Patients with Locally Advanced Rectal Cancer-A Systematic Review.Life (Basel, Switzerland) · 2025Review
- Circulating tumor DNA in colorectal cancer: biology, methods and applications.Discover oncology · 2025Review
- Total neoadjuvant therapy in high-risk rectal cancer: organ preservation and survival outcomes in a single-center retrospective cohort.Therapeutic advances in medical oncology · 2025Article
Corrections and comments
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Authors and funding
20 authors.
Funding
Abstract
backgroundTotal neoadjuvant therapy (TNT) has been used for patients with locally advanced rectal cancer. The optimal sequence of chemoradiotherapy (CRT) and chemotherapy (CT) is a matter of debate.
methodsWe performed a pooled analysis of the CAO/ARO/AIO-12 and OPRA multicenter, randomized phase 2 trials to identify patient subsets that could benefit from one TNT sequence over the other regarding disease-free survival (DFS). Patients with stage II/III rectal cancer were randomized to CRT (50.4-54 Gy) with either induction (INCT-CRT) or consolidation CT (CRT-CNCT) with fluorouracil, leucovorin, oxaliplatin (CAO/ARO/AIO-12 and OPRA) or capecitabine and oxaliplatin (OPRA) followed by mandatory total mesorectal excision (TME) (CAO/ARO/AIO-12) or selective watch-and-wait surveillance (OPRA). 311 and 324 patients were recruited from June 15, 2015 to January 31, 2018; and from April 12, 2014 to March 30, 2020 in the two trials, respectively. Pretreatment clinical and tumor characteristics included were age, sex, ECOG, cT-category, cN-category, clinical UICC stage, location from anal verge, and tumor grade.
findingsIn total, 628 eligible patients were included in the pooled analysis (CAO/ARO/AIO-12, n = 304; OPRA, n = 324). Of those, 313 were randomly assigned to the INCT-CRT group, and 315 to the CRT-CNCT group. Median follow-up was 43 months (IQR, 35-49) months in the CAO/ARO/AIO-12 trial and 61,2 months (IQR, 42-68,4) in the OPRA trial. Pooled analysis of baseline clinical and tumor characteristics did not identify any subgroups of patients that would benefit by the one TNT sequence over the other with regard to DFS.
interpretationTo our knowledge, this is the first pooled analysis of two randomized trials after direct head-to-head comparison of both TNT sequences. Both trials reported higher rates of complete response with CRT-CNCT, and this should be considered the preferred TNT sequence if organ preservation is a priority.
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