Rectal cancer has not been the subject of any major progress since 2004. But since the recent publication of the PRODIGE 23 study, the situation could change.
This is cancer that develops from polyps in the wall lining the inside of the colon. Polyps are small, fleshy growths. There are several kinds. Most often, they are benign. However, it is known that some of them can become cancerous. It takes an average of 10 years for a polyp to form a cancerous tumor. According to Public Health France, rectal cancer is the third most frequent tumor in men and second in women (43,336 new cases each year).
But a new treatment strategy for rectal cancer has just been validated by the results of a study called PRODIGE 23. Behind this research published in the journal le Lancet Oncology , Prof. Thierry Conroy, oncologist specializing in digestive cancers and Managing Director of the Lorraine Institute of Cancerology. “Since 2004, there has been no major breakthrough in the management of locally advanced rectal cancers. Finally, here is one! We are happy to bring new perspectives to patients: improvement of survival without recurrence of cancer, reduction significant development of metastases and a reduction in adverse effects “, underlines Unicancer through a press release.
Two-step chemotherapy
The study was carried out on 431 patients subject to a recent diagnosis of locally advanced rectal cancer (stage II or III). In normal management, chemotherapy is given before surgery to remove the tumor. But with Professor Thierry Conroy’s team, the treatment takes another turn and chemotherapy is split into two parts. Thus, in this new protocol, half of the chemotherapy is carried out before the operation and the other half after the operation. Another notable difference is that the order of treatment has been changed and the preoperative chemotherapy has been emphasized (4 anticancer agents instead of 3 previously). However, the total duration of treatment remains unchanged.
According to the authors of the study, splitting chemotherapy in two (in the case of colon cancer) increases the chances of survival by 31% without suffering a relapse. Other benefits of this two-part chemotherapy highlight that it is a major breakthrough, since patients have experienced a 36% reduction in the risk of metastases occurring, less serious complications. postoperative or even no operative mortality.
On the other hand, the researchers do not have sufficient hindsight to definitively pronounce on their discoveries. But according to Unicancer “The extremely encouraging signs point to a marked increase in longer-term survival.”