Discussion
tumor, rectal cancer, OS
TUMOR, RECTAL CANCER
The time-dependent trend of OS among patients with rectal cancer after experiencing treatment failure after initial curative treatment has remained largely unexplored, to our knowledge. We examined the OS trends among patients with rectal cancer treated within 3 large randomized trials of the GRCSG during the past 3 decades. We provide evidence that OS after treatment failure has improved significantly in the more recent CAO/ARO/AIO-04 trial and, even more, in the CAO/ARO/AIO-12 trial compared with the older CAO/ARO/AIO-94 trial. This finding likely reflects the advancements in salvage treatment options, including systemic therapy with combination chemotherapy protocols, druggable molecular tumor targets (such as anti-angiogenesis [bevacizumab]), anti–epidermal growth factor receptor (cetuximab or panitumumab), and immunotherapy (pembrolizumab), as well as improvements in surgery and radiotherapy (eg, local stereotactic ablative radiotherapy for oligometastatic treatment) as part of the multidisciplinary approach for patients with rectal cancer who experienced treatment failure after initial curative therapy during the past decades.The RAPIDO and the PRODIGE23 randomized phase 3 trials showed improved pCR and DFS but initially failed to demonstrate improved OS after TNT compared with CRT, surgery, and (optional) adjuvant chemotherapy.