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Preoperative Oxaliplatin Does Not Shrink Rectal Tumors

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  2. Preoperative Oxaliplatin Does Not Shrink Rectal Tumors

Adding oxaliplatin (Eloxatin) to standard preoperative radiochemotherapy does not lead to tumor shrinkage in patients with locally advanced rectal cancer, according to a large, multicenter, phase 3 Italian study presented at the 2009 ASCO Annual Meeting. Still, researchers say the drug may reduce the number of distant metastases, according to preliminary data. Oxaliplatin is used commonly in patients with more advanced colon and rectal cancer and has been effective in treating these patients.

The trial involved 747 patients with locally advanced rectal cancer who were randomized to receive standard preoperative therapy or the standard plus oxaliplatin. No significant differences were found between the 2 groups in terms of tumor reduction or the number of patients who had cancer in the lymph nodes. The proportion of patients who could have conservative surgeries also was similar in both groups. Researchers did find, however, that only 0.5% (2) of patients in the oxaliplatin group had distant metastases, whereas 3% (11 patients) had them in the control arm.

The difference between the 2 groups is significant enough to suggest that lack of tumor shrinkage does not necessarily mean the drug does not have an effect on micrometastases at distant sites, notes Carol Aschele, MD, PhD, attending physician and lead clinician in colorectal/gastrointestinal cancer in the Department of Medical Oncology and Cancer Prevention at E.O.Ospedali Galliera in Genoa, Italy and the study's first author. He adds the additional follow-up is needed to determine whether oxaliplatin will play a role in recurrence or survival rates.