In an N+ rectal adenocarcinoma treated via PROSPECT with neoadjuvant FOLFOX with omission of CRT and no treatment response in the primary on pathology (ypN+), would you offer adjuvant chemotherapy or chemo-radiation?

Would the lack of treatment response concern you enough to offer adjuvant chemo-RT, despite PROSPECT only pursuing adjuvant chemo-RT in the FOLFOX with omission group following an R+ resection?

Answer from: Radiation Oncologist at Academic Institution

Adjuvant FOLFOX was allowed in PROSPECT, and most patients received it. Presumably, patients with ypN+ disease were most likely to receive adjuvant FOLFOX. We do not (yet) have recurrence data broken down by ypN stage, but as the overall LR rate was less than 2%, I would not consider the lack of his...

Comments

Radiation Oncologist at Rush University Medical Center
I would like to know more about what "lack of trea...

Radiation Oncologist at Radiation Medicine Associates
Thank you both for your engagement. The lack of r...

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In an N+ rectal adenocarcinoma treated via PROSPECT with neoadjuvant FOLFOX with omission of CRT and no treatment response in the primary on pathology (ypN+), would you offer adjuvant chemotherapy or chemo-radiation?

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