Early regression index-guided adaptive dose escalation in locally advanced rectal cancer: results of the prospective THUNDER-2 trial.

Radiother OncolAug 4, 2026 (epub)
Clinical ResearchOncology (Medical)Radiology (Diagnostic)

G Chiloiro, A Romano, L Boldrini et al.

✦ AI-curated · Sources linked

In 30 seconds

The THUNDER-2 trial evaluated the effectiveness of Early Regression Index (ERI)-guided adaptive dose escalation in patients with locally advanced rectal cancer (LARC) undergoing neoadjuvant chemoradiotherapy. This prospective clinical trial found that adaptive dose escalation increased the complete response (CR) rate in predicted non-responders from approximately 3% to 21.9%, while maintaining acceptable toxicity levels.

Key findings

  • Adaptive dose escalation increased CR rates in non-responders from approximately 3% to 21.9%.
  • Responders had a TME-free survival of 38.7% compared to 8.3% in non-responders (HR 2.35).
  • ERI was significantly associated with CR in both univariate and multivariable analyses (adjusted OR 0.912).

Why it matters

This study highlights the potential of using imaging biomarkers like ERI to personalize treatment in LARC, which may enhance CR rates and support organ-preserving strategies, ultimately improving patient outcomes.

Source

PubMed · PMID 42551632

Published in Radiother Oncol. This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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