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ctDNA-Based Adjuvant Chemotherapy for High-Risk Rectal Cancer
ctDNA-Based Adjuvant Chemotherapy for High-Risk Rectal Cancer

NCT07188025

RecruitingPhase 3

Sponsor: Erasmus Medical Center

Conditions: Rectal Cancer

Interventions: Adjuvant chemotherapy

Countries: Netherlands

The goal of this clinical trial is to investigate whether adjuvant chemotherapy can prevent disease recurrence in patients with high-risk rectal cancer who have detectable ctDNA after surgery. The main research question the REACT study aims to answer is: \- Does adjuvant chemotherapy improve disease-free survival in patients with high-risk rectal cancer with detectable ctDNA after surgery? Interventions: \- Patients with detectable ctDNA after surgery and randomised to the experimental group will be offered adjuvant chemotherapy (4 cycles CAPOX/6 cycles FOLFOX) within 12 weeks after surgery.

Eligibility overview

Sex: ALL

Age: 18 Years to

Healthy volunteers: No

Study type: INTERVENTIONAL

Eligibility criteria
Inclusion Criteria

* Detectable ctDNA in the postoperative blood sample
* Age ≥ 18 years
* WHO performance score 0-1
* Informed consent for PLCRC with specific consent for additional blood withdrawals and offering of future experimental research
* Informed consent for the REACT trial.
* Histological confirmed rectal cancer; either treated with neoadjuvant (chemo)radiotherapy, and/or clinical/pathological T3/T4 and/or N+ in case no neoadjuvant therapy was administered.
* Eligible to receive treatment with combination adjuvant chemotherapy (CAPOX/FOLFOX) according to the treating physician.
* Mentally competent and able to read and understand Dutch language.

Exclusion Criteria:

* Metastatic disease
* Another malignancy in previous 5 years, with the exception of treated carcinoma in situ or skin cancer other than melanoma
* Incomplete primary tumour resection (R1 or R2 resection)
* Contra-indication for fluoropyrimidines or oxaliplatin
* Neoadjuvant oxaliplatin based systemic treatment, e.g. treated with the RAPIDO regimen consisting of short course radiotherapy followed by 6 cycles of CAPOX or 9 cycles of FOLFOX prior to surgery
* Patients with a clinical complete response, who will not undergo surgery.
* Pregnant and lactating women
* History of psychiatric disability judged by the investigator to be clinically significant, precluding informed consent or interfering with compliance of the intervention group
* Serious concomitant systemic disorders that would compromise the safety of the patient or his/her ability to complete the study, at the discretion of the investigator
* Serious infections (uncontrolled or requiring treatment)
* Current or recent (within 28 days prior to randomisation) treatment with another investigational drug or participation in another study interfering with the primary endpoint.
Locations (25)
  • 's-Hertogenbosch, Netherlands
  • Almelo, Netherlands
  • Amersfoort, Netherlands
  • Amsterdam, Netherlands
  • Breda, Netherlands
  • Delft, Netherlands
  • Dordrecht, Netherlands
  • Eindhoven, Netherlands
  • Goes, Netherlands
  • Groningen, Netherlands
  • Hoorn, Netherlands
  • Leeuwarden, Netherlands
  • Leiden, Netherlands
  • Nijmegen, Netherlands
  • Nijmegen, Netherlands
  • Roosendaal, Netherlands
  • Rotterdam, Netherlands
  • Rotterdam, Netherlands
  • Rotterdam, Netherlands
  • Rotterdam, Netherlands
  • Sneek, Netherlands
  • Terneuzen, Netherlands
  • The Hague, Netherlands
  • Tilburg, Netherlands
  • Uden, Netherlands