AI Article Synopsis
Article Abstract
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.
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.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8417863 | PMC |
| http://dx.doi.org/10.1002/onco.13824 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Breast cancers with neuroendocrine differentiation: Retrospective case studies series from a single institution based on the 2019 WHO classification.
Cancer Treat Res Commun
December 2024
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address:
Background: The World Health Organization's fifth edition of tumor series classification was published in 2019 and adopted the term 'Neuroendocrine neoplasm (NEN)' to encompass all tumor classes with predominant neuroendocrine differentiation (NED). Based on the updated classification of the NEN, we conducted a case series using the Clinical Data Warehouse platform of SMC.
Methods: In this retrospective study, breast NENs and invasive breast carcinomas no special type (IBCNST) with NED, were defined as 'NENS'.
Neoadjuvant Chemotherapy VI-RADS Scores for Assessing Muscle-invasive Bladder Cancer Response to Neoadjuvant Immunotherapy with Multiparametric MRI.
Radiology
December 2024
From the Departments of Radiology (G. Brembilla, M.C., A.D.P., T.R., R.P., S.L., F.D.C.), Urology (G. Basile, M.B., M.M., A.B., F.M.), and Medical Oncology (D.R., C.M., V.T., A.C., D.P., E.C., A.N.), IRCCS Ospedale San Raffaele, Milan, Italy; Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy (G. Brembilla, G. Basile, M.C., T.R., R.P., D.P., E.C., M.B., M.M., A.B., F.M., A.N., F.D.C.); Division of Surgery and Interventional Science, University College London, London, United Kingdom (F.G.); Department of Radiology, University College London Hospital NHS Foundation Trust, London, United Kingdom (F.G.); Genitourinary Department, Programma Prostata (P.G.) and Department of Radiology (A. Messina, G. Calareso), Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Tex (A. Martini); and Department of Radiology, IRCCS Ospedale San Raffaele-Turro, Milan, Italy (G. Cardone).
Background An accurate method of assessing the response of muscle-invasive bladder cancer (MIBC) to neoadjuvant treatment is needed for selecting candidates for bladder-sparing strategies. Purpose To evaluate the diagnostic accuracy and reproducibility of neoadjuvant chemotherapy Vesical Imaging Reporting and Data System (nacVI-RADS) scores and posttreatment Vesical Imaging Reporting and Data System (VI-RADS) scores when assessing MIBC response to neoadjuvant immunotherapy with multiparametric MRI (mpMRI). Materials and Methods A retrospective analysis of MRI scans was conducted in patients enrolled in the PURE-01 study (NCT02736266) from February 2017 to December 2019 who underwent pre- and postimmunotherapy mpMRI before radical cystectomy.
View Article and Find Full Text PDFPurpose: There is no current standard treatment regimen for carcinoma ex pleomorphic adenoma (CXPA) of the lacrimal gland. Neoadjuvant intraarterial cytoreductive chemotherapy (IACC) followed by multimodal therapy has achieved good locoregional control in adenoid cystic carcinoma of the lacrimal gland. We reviewed our experience with neoadjuvant IACC followed by multimodal therapy for CXPA of the lacrimal gland.
View Article and Find Full Text PDFPerioperative and recurrence-free survival outcomes after laparoscopic hepatectomy for colorectal cancer liver metastases using indocyanine green fluorescence imaging: an inverse probability treatment weighted analysis.
Surg Endosc
December 2024
Department of General Surgery, Peking University Third Hospital, Beijing, 100191, China.
Background: Colorectal cancer (CRC) frequently metastasizes to the liver, significantly worsening patient outcomes. While hepatectomy offers the best curative option for colorectal liver metastases (CRLM), margin recurrence remains a major challenge post-surgery. Intraoperative ultrasound (IOUS) aids tumor identification and margin determination, but its limitations in laparoscopic surgery necessitate additional methods.
View Article and Find Full Text PDFMachine Learning to Predict the Individual Risk of Treatment-Relevant Toxicity for Patients With Breast Cancer Undergoing Neoadjuvant Systemic Treatment.
JCO Clin Cancer Inform
December 2024
Department of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, Germany.
Purpose: Toxicity to systemic cancer treatment represents a major anxiety for patients and a challenge to treatment plans. We aimed to develop machine learning algorithms for the upfront prediction of an individual's risk of experiencing treatment-relevant toxicity during the course of treatment.
Methods: Clinical records were retrieved from a single-center, consecutive cohort of patients who underwent neoadjuvant treatment for early breast cancer.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!