Overview

SMART TNT for the Conservative Management of Locally Advanced Rectal Cancer

Status:
Not yet recruiting
Trial end date:
2027-06-30
Target enrollment:
0
Participant gender:
All
Summary
The purpose of this research study is to find out how safe and effective is treating patients with locally advanced rectal cancer (LARC) with chemotherapy first and then follow with radiation therapy to a higher dose than what is usually delivered and see if patients could have complete response and be spared from surgery.
Phase:
Phase 1
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
University of Miami
Treatments:
Capecitabine
Fluorouracil
Leucovorin
Oxaliplatin
Criteria
Inclusion Criteria:

1. Patients with newly diagnosed, biopsy proven, rectal adenocarcinoma.

2. Primary tumor located ≤18 cm from margin verge.

3. Primary tumor either a T3N0 or T1-4 N positive (as defined per pelvic MRI; nodes ≤ 15
mm).

4. ≥ 18 years of age.

5. Eastern Cooperative Oncology Group (ECOG) performance status 0-2.

6. Serum liver function tests values within the range of 1.5 x Upper Limit of Normal
(within 6 weeks of enrollment).

7. Negative pregnancy test for women of child-bearing potential (within 4 weeks of
enrollment).

8. Ability to understand and the willingness to sign a written informed consent document.

9. Patient is assessed by a surgeon, medical oncologist and a radiation oncologist and
deemed fit for Total Neoadjuvant ChemoTherapy (TNT) and surgery.

Exclusion Criteria:

1. Metastatic disease on initial work up (Chest and abdomen contrast enhanced CT scan).

2. Synchronous lesion found on colonoscopy.

3. Previous history of pelvic radiotherapy.

4. History of concurrent, active malignancy, other than non metastatic skin cancer within
the last 5 years.

5. Symptomatic congestive heart failure of New York Heart Association Class III or IV,
unstable angina pectoris or serious uncontrolled cardiac arrhythmia, myocardial
infarction within the last 6 months.

6. Psychiatric illness/social situations that would limit compliance with study
requirements.

7. Active (acute or chronic) or uncontrolled severe infections requiring intravenous
antibiotics or active tuberculosis (TB).

8. Acquired immune deficiency syndrome (AIDS) based upon current Centers for Disease
Control (CDC) definition or known HIV seropositivity; note, however, HIV testing is
not required for entry into this protocol. The need to exclude patients with HIV/AIDS
from this protocol is based on the fact that the treatments involved in this protocol
may be significantly immunosuppressive.

9. Active connective tissue disorders, such as lupus or scleroderma, that in the opinion
of the treating physician may put the patient at high risk for radiation toxicity

10. Sensory or motor neuropathy ≥ grade 2.

11. Women who are breast feeding.

12. Exclusions due to MRI use in study: ferromagnetic metal in body/eye, pacemaker,
defibrillator, other mechanical device, or extreme claustrophobia (medication with
anti-anxiety agents, such as Ativan, may be attempted).