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Neoadjuvant mFOLFIRINOX improves DFS, OS effect uncertain

Key clinical point: Adding neoadjuvant chemotherapy to standard treatment of locally advanced rectal cancer improved 3-year disease-free survival, but the effect on overall survival is unclear.

Major finding: The 3-year disease-free survival was 68.5% with standard therapy and 75.7% with the addition of neoadjuvant chemotherapy (P = .034).

Study details: A phase 3 trial of 461 patients with locally advanced rectal cancer randomized to the standard therapy arm – radiation plus capecitabine, total mesorectal excision, and 6 months of FOLFOX (folinic acid, fluorouracil, and oxaliplatin) or XELOX (capecitabine and oxaliplatin) – or the neoadjuvant chemotherapy arm – six cycles of modified FOLFIRINOX (oxaliplatin, irinotecan, folinic acid, and 5-fluorouracil), radiation plus capecitabine, total mesorectal excision, and FOLFOX/XELOX for 3 months instead of 6 months.

Disclosures: The study, PRODIGE 23, was funded by the French National Cancer Institute and the French National League Against Cancer. The presenter disclosed relationships with Roche, Servier, Pierre Fabre, and Merck Sharp & Dohme.


Borg C et al. ESMO 2020. Abstract LBA21.