Novel strategies for organ sparing in patients with complete response to radiochemotherapy in Iocally advanced rectal cancer

 

Financing: Agentschap voor Innovatie door Wetenschap en Technologie  (IWT)

Project reference Nr.: K.B.O. 0442.528.054
Start: 2014-01-01
End: 2017-12-31

Description:

Novel strategies for organ sparing in patients with complete response to radiochemotherapy in Iocally advanced rectal cancer

Rectal cancer accounts for about 30% of all colorectal tumours, which are the second leading cause of cancer-related death in the Western world. About 70 % of the patients with rectal cancer present with stage II-III disease at diagnosis. The standard treatment for these patients is neo-adjuvant radiochemotherapy (RCT) followed by a total mesorectal excision (TME). Several studies however indicate that up to 20% of these patients achieve pathologic complete response (pCR) after RCT and might therefore be spared from surgery. The primary objective of this study is therefore to develop reliable methods for identifying this sub-group of patients. 
For this purpose we will: 


I. Assess the sensitivity and specificity of diffusion weighted MRI (DW-MRI), Gadofosveset-MRI (GDF-MRI) and 18F-FDG-PET in the presurgical response evaluation, confirming promising preliminary results. 


II. Set up a response signature based on the clinical, imaging data and the molecular markers evaluated in a first clinical study (explorative study). 


III. Validate the power of the signature in a validation study in which patients are selected for surgery or the ‘wait and see’ option based on this response signature. 
With this project, we hope to make a leap forward in the individualization of the treatment for patients with locally advanced rectal cancer. Identification of patients with a complete response can spare these patients from the invasive surgery and significantly improve their quality of life. 


 

SMC people involved in the project: