Revolutionary study in Cologne: New hopes against rectal cancer!

Revolutionary study in Cologne: New hopes against rectal cancer!

The University Hospital of Cologne (UKK) has received a funding commitment of over one million euros from the German Cancer Aid for a groundbreaking clinical study that deals with the treatment of rectal cancer in older patients. Under the direction of Univ.-Prof. Dr. Dr. According to Dr. Emmanouil Fokas, the study will be carried out at 20 centers in Germany. Every year, over 20,000 people in Germany develop rectal cancer, which illustrates the urgency of such research projects. In the past, the German Rectal Cancer Study Group (GRCSG) has made a significant contribution to the optimization of multimodal standard therapy.

The aim of the current study, known as ACO/ARO/AIO-22, is to examine the possibility of avoiding radical surgery, particularly in patients who respond well to preoperative therapies. This approach is called a “watch and wait” strategy. Prof. Fokas emphasizes that if there is a complete response to preoperative therapy, long-term healing may be possible without surgical tumor removal. The study is aimed specifically at older patients aged 70 and over who cannot receive comprehensive surgical therapy.

Intensified therapeutic approaches

Clinical experience shows that intensified therapies before surgery for locally advanced rectal cancer significantly improve disease-free survival and reduce the risk of metastases. According to the results of various studies, it can be observed that the number of patients in whom tumor cells could no longer be detected after surgery is increasing. The standard therapy to date includes a combination of radiation (chemo)therapy and subsequent surgery. The newer intensified approaches supplement this standard therapy with additional chemotherapy.

A central aspect of therapy is tumor reduction. This not only allows for better local tumor control but also helps preserve the sphincter. One of the most promising treatment strategies is “total neoadjuvant therapy” (TNT), which has shown positive results in several studies. Thus, the PRODIGE 23 study found that in patients who received chemoradiotherapy, a pathological complete response was found in 27.8% of cases.

Encouraging results from research

The results of the TNT approach are encouraging: after three years, there was a disease-free survival of 75.7% in intensively treated patients compared to 68.5% with standard therapy. Metastasis-free survival rates also improved: 78.8% versus 71.1%. The RAPIDO study delivered similar results, in which a pathological complete response of 28% with TNT compared to 14% with standard therapy was observed in high-risk patients.

In addition, the “Watch & Wait” concept allows a decision against surgery if there is a complete remission. Instead, regular monitoring is carried out and surgery is only considered if the tumor grows again. These developments make the discussion in the multidisciplinary team about the new therapeutic approaches and the “watch & wait” strategies all the more relevant.

In summary, the clinical study led by Prof. Fokas shows great potential to redefine the standards in the treatment of rectal cancer in older patients and to significantly increase the quality of life of those affected. With the support of the German Cancer Aid, a significant step has been taken in improving treatment strategies.

For more information about advances in rectal cancer treatment, read reports from Cologne University Hospital, DEGRO and other relevant sources.