Short‐Term Results of the SONCAR Study: Optimized Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Patients

ABSTRACT This research endeavored to ascertain whether four cycles of oxaliplatin in conjunction with standard radiation (oxaliplatin‐CRT) could enhance overall survival when compared with standard neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC). A Phase III randomized...

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Main Authors: Rongxin Zhang, Fulong Wang, Xinhua Jiang, Hao Wang, Weili Zhang, Zhifan Zeng, Yuanhong Gao, Xiaojun Wu, Gong Chen, Liren Li, Peirong Ding, Shixun Lu, Jian Zhang, Min Liu, Qiaoxuan Wang, Weiwei Xiao, Zhizhong Pan, Desen Wan, Zhen‐hai Lu
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:MedComm
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Online Access:https://doi.org/10.1002/mco2.70222
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author Rongxin Zhang
Fulong Wang
Xinhua Jiang
Hao Wang
Weili Zhang
Zhifan Zeng
Yuanhong Gao
Xiaojun Wu
Gong Chen
Liren Li
Peirong Ding
Shixun Lu
Jian Zhang
Min Liu
Qiaoxuan Wang
Weiwei Xiao
Zhizhong Pan
Desen Wan
Zhen‐hai Lu
author_facet Rongxin Zhang
Fulong Wang
Xinhua Jiang
Hao Wang
Weili Zhang
Zhifan Zeng
Yuanhong Gao
Xiaojun Wu
Gong Chen
Liren Li
Peirong Ding
Shixun Lu
Jian Zhang
Min Liu
Qiaoxuan Wang
Weiwei Xiao
Zhizhong Pan
Desen Wan
Zhen‐hai Lu
author_sort Rongxin Zhang
collection DOAJ
description ABSTRACT This research endeavored to ascertain whether four cycles of oxaliplatin in conjunction with standard radiation (oxaliplatin‐CRT) could enhance overall survival when compared with standard neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC). A Phase III randomized trial (SONCAR Trial, NCT02031939) was conducted in China, involving patients diagnosed with clinical T3‐4 and/or N+ rectal cancer. Patients were randomly allocated to the experimental arm (receiving pelvic radiation (50 Gy/25 fractions) in conjunction with oxaliplatin and capecitabine) or the control arm (pelvic radiation in conjunction with capecitabine alone). The main endpoint was a 5‐year OS, while the secondary objectives encompassed pathological complete response (pCR), 3‐year disease‐free survival, and surgical complications. A total of 536 patients were assessable. The rate of pCR was notably higher in the experimental group (31.9%) than in the control group (21.5%) (p = 0.008). The clinical complete response (cCR) rate was also higher in the experimental group (p = 0.024). Among patients with tumors located within 5 cm of the anal verge, the experimental group exhibited a significantly greater tumor regression, with rates of 33.8% compared to 21.6% in the control group (p = 0.024). In summary, oxaliplatin‐CRT significantly augmented the tumor response in LARC patients with manageable toxicity.
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spelling doaj-art-dc0ecdbdf628495b82a690d90bafe4cb2025-08-20T04:02:50ZengWileyMedComm2688-26632025-08-0168n/an/a10.1002/mco2.70222Short‐Term Results of the SONCAR Study: Optimized Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer PatientsRongxin Zhang0Fulong Wang1Xinhua Jiang2Hao Wang3Weili Zhang4Zhifan Zeng5Yuanhong Gao6Xiaojun Wu7Gong Chen8Liren Li9Peirong Ding10Shixun Lu11Jian Zhang12Min Liu13Qiaoxuan Wang14Weiwei Xiao15Zhizhong Pan16Desen Wan17Zhen‐hai Lu18Department of Colorectal SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongChinaDepartment of Colorectal SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongChinaState Key Laboratory of Oncology in South ChinaGuangzhouGuangdongChinaDepartment of Colorectal SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongChinaDepartment of Colorectal SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongChinaState Key Laboratory of Oncology in South ChinaGuangzhouGuangdongChinaState Key Laboratory of Oncology in South ChinaGuangzhouGuangdongChinaDepartment of Colorectal SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongChinaDepartment of Colorectal SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongChinaDepartment of Colorectal SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongChinaDepartment of Colorectal SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongChinaState Key Laboratory of Oncology in South ChinaGuangzhouGuangdongChinaState Key Laboratory of OphthalmologyZhongshan Ophthalmic CenterSun Yat‐sen UniversityGuangzhouGuangdongChinaState Key Laboratory of Oncology in South ChinaGuangzhouGuangdongChinaState Key Laboratory of Oncology in South ChinaGuangzhouGuangdongChinaState Key Laboratory of Oncology in South ChinaGuangzhouGuangdongChinaDepartment of Colorectal SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongChinaDepartment of Colorectal SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongChinaDepartment of Colorectal SurgerySun Yat‐sen University Cancer CenterGuangzhouGuangdongChinaABSTRACT This research endeavored to ascertain whether four cycles of oxaliplatin in conjunction with standard radiation (oxaliplatin‐CRT) could enhance overall survival when compared with standard neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer (LARC). A Phase III randomized trial (SONCAR Trial, NCT02031939) was conducted in China, involving patients diagnosed with clinical T3‐4 and/or N+ rectal cancer. Patients were randomly allocated to the experimental arm (receiving pelvic radiation (50 Gy/25 fractions) in conjunction with oxaliplatin and capecitabine) or the control arm (pelvic radiation in conjunction with capecitabine alone). The main endpoint was a 5‐year OS, while the secondary objectives encompassed pathological complete response (pCR), 3‐year disease‐free survival, and surgical complications. A total of 536 patients were assessable. The rate of pCR was notably higher in the experimental group (31.9%) than in the control group (21.5%) (p = 0.008). The clinical complete response (cCR) rate was also higher in the experimental group (p = 0.024). Among patients with tumors located within 5 cm of the anal verge, the experimental group exhibited a significantly greater tumor regression, with rates of 33.8% compared to 21.6% in the control group (p = 0.024). In summary, oxaliplatin‐CRT significantly augmented the tumor response in LARC patients with manageable toxicity.https://doi.org/10.1002/mco2.70222locally advanced rectal cancerneoadjuvant chemoradiotherapyoxaliplatintoxicity
spellingShingle Rongxin Zhang
Fulong Wang
Xinhua Jiang
Hao Wang
Weili Zhang
Zhifan Zeng
Yuanhong Gao
Xiaojun Wu
Gong Chen
Liren Li
Peirong Ding
Shixun Lu
Jian Zhang
Min Liu
Qiaoxuan Wang
Weiwei Xiao
Zhizhong Pan
Desen Wan
Zhen‐hai Lu
Short‐Term Results of the SONCAR Study: Optimized Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Patients
MedComm
locally advanced rectal cancer
neoadjuvant chemoradiotherapy
oxaliplatin
toxicity
title Short‐Term Results of the SONCAR Study: Optimized Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Patients
title_full Short‐Term Results of the SONCAR Study: Optimized Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Patients
title_fullStr Short‐Term Results of the SONCAR Study: Optimized Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Patients
title_full_unstemmed Short‐Term Results of the SONCAR Study: Optimized Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Patients
title_short Short‐Term Results of the SONCAR Study: Optimized Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer Patients
title_sort short term results of the soncar study optimized neoadjuvant chemoradiotherapy in locally advanced rectal cancer patients
topic locally advanced rectal cancer
neoadjuvant chemoradiotherapy
oxaliplatin
toxicity
url https://doi.org/10.1002/mco2.70222
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