Chemoradiotherapy versus short-course radiotherapy for response-adapted organ preservation in early-stage and intermediate-stage rectal cancer (STAR-TREC): 12-month results of an international, multicentre, open-label, parallel-group, randomised, phase 2/3 trial.
Simon P Bach, David Sebag-Montefiore, Victoria Homer et al.
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In 30 seconds
The STAR-TREC trial evaluated long-course chemoradiotherapy (LCCRT) versus short-course radiotherapy (SCRT) for organ preservation in early-stage and intermediate-stage rectal cancer. In a multicentre, randomised phase 2/3 trial involving 503 participants, 12-month TME-free survival was significantly higher with LCCRT at 78.5% compared to 60.6% with SCRT, indicating a potential benefit of LCCRT in preserving organ function without compromising oncological outcomes.
Key findings
- 12-month TME-free survival was 60% overall among participants.
- LCCRT showed a median TME-free survival not reached compared to 7.6 months for SCRT (HR 3.7).
- Among organ preservation participants, 12-month TME-free survival was 78.5% for LCCRT versus 60.6% for SCRT (HR 1.90).
- The most common serious adverse events were gastrointestinal disorders, occurring in 2% with LCCRT.
Why it matters
These findings suggest that LCCRT may enhance organ preservation in rectal cancer treatment, potentially reducing the need for total mesorectal excision and its associated complications, thereby improving patient quality of life.