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Total Neoadjuvant Therapy With Additional Consolidation Chemotherapy Followed by Local Excision Versus Total Neoadjuvant Therapy Followed by Local Excision at Stage I Rectal Cancer

NCT07563907 · tracked via the Priya Life Science South Korea tracker
Phase
Not applicable
Started
2026-06-01
Last updated
2026-05-04

Condition(s) studied

Organ PreservationRectal Cancer Stage ITotal Neoadjuvant TreatmentConsolidation TherapyCapecitabine

Investigational drug(s) / intervention(s)

TNT with additional consolidation chemotherapy followed by local excisionTNT followed by local excision

TNT with additional consolidation chemotherapy followed by local excision: 5-FU based CCRT: 5 weeks Rest period: 1 week 5-FU (Capecitabine) Consolidation chemotherapy 3 cycles: 8 weeks Rest period: 1 week Local excision

TNT followed by local excision: 5-FU based CCRT: 5 weeks Rest period: 10 weeks Local excision

Study summary

Safety and Efficacy of Organ Preservation Treatment for Stage I Rectal Cancer: Optimization of Consolidation Chemotherapy Before Local Excision After Neoadjuvant Chemoradiotherapy (OPTION); A Multi-center, Prospective, Randomized Trial

The goal of this clinical trial is to find out if adding consolidation chemotherapy with capecitabine after total neoadjuvant chemoradiotherapy (TNT) works to improve oncologic outcomes in patients with stage I rectal cancer. It will also comparethe safety of adding consolidation chemotherapy before local excision.

The main questions it aims to answer are:

* Does adding consolidation chemotherapy increase the rate of pathologic complete response?
* What medical problems or side effects do participants have during and after treatment?

Researchers will compare TNT followed by local excision to TNT followed by consolidation chemotherapy with capecitabine and then local excision to see if adding consolidation chemotherapy improves tumor response and treatment outcomes.

Participants will:

* Receive TNT for stage I rectal cancer
* Be randomly assigned to one of two treatment groups
* Undergo local excision after preoperative treatment
* Visit the clinic for checkups and tests to evaluate tumor response, side effects, recurrence, survival, quality of life, bowel function, urinary function, sexual function, circulating tumor DNA, and treatment-related costs

Eligibility

Sex
ALL
Min age
19 Years
Max age
79 Years
Healthy volunteers
No
Inclusion Criteria: * Histologically confirmed rectall adenocarcinoma * Low rectal cancer (AV \< 15cm) * cT2N0 disease, or pathologic stage T1N0 disease after endoscopic resection with at least one high-risk feature, including: Positive resection margin Lymphovascular invasion Tumor budding ≥5 * Ability to understand and comply with the requirements of the clinical trial Exclusion Criteria: * Patients who prefer radical rectal resection * Prior history of surgery for rectal cancer * Recurrent rectal cancer * Synchronous metastatic rectal cancer * Evidence of lymph node metastasis or distant metastasis on abdominopelvic CT or chest CT, including para-aortic, common iliac, or external iliac lymph node metastasis * Uncontrolled active infection or other uncontrolled medical condition * Known hypersensitivity to chemotherapy * Patients considered unsuitable for participation in the clinical trial by the principal investigator or study personnel

Primary outcome measure(s)

  • Pathologic complete response rate (ypT0) — At pathologic assessment of the local excision specimen, approximately 10 weeks after completion of TNT
    Pathologic complete response of the primary tumor after neoadjuvant therapy

Trial sites (1)

FacilityCityRegionStatus
Seoul National University Hospital Seoul Jongro-gu
Official registry record

This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.

View NCT07563907 on ClinicalTrials.gov ↗ ← All trials in South Korea