Rectal Cancer And Pre-operative Induction Therapy Followed by Dedicated Operation. The RAPIDO Trial
Running, not enrolling · Phase 3
Conditions studied: Rectal Cancer
In brief
Currently the 3-year disease free survival of patients with locally advanced rectal cancer is about 50%. Current standard treatment for patients at high risk of failing locally and/or systemically includes pre-operative long course radiotherapy (5 weeks) in combination with chemotherapy (so called neoadjuvant chemoradiotherapy). The neoadjuvant chemoradiotherapy has been demonstrated to improve local control, but had no effect on the overall survival. Different studies in patients with rectal cancer studying the effect of adjuvant post operative chemotherapy did not result in an improved survival. This may be due the fact that rectal cancer surgery (TME) is associated with a high complication rate so substantial proportion of patients cannot receive chemotherapy postoperatively. An alternative approach is to administer the systemic therapy preoperative. To guarantee control of the rectum tumor short-course radiotherapy (5 days) is given, as different studies showed local control of the tumor for a long time. During this waiting period the patient is in a good condition to receive an optimal dose of chemotherapy. The investigators hypothesize that with this proposed protocol both the local tumour and possible micrometastases are effectively treated and that this will result in an increased survival. The investigators will compare this with the standard treatment of neoadjuvant chemoradiation followed by TME surgery and optional adjuvant chemotherapy.
Key facts
- Study ID
- NCT01558921
- Run by
- University Medical Center Groningen
- People needed
- 920
- Starts
- 2011-06-21
- Expected to finish
- 2026-12-31
- Last updated by the study team
- 2026-05-01
Who can join
Age: 18 and older. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Primary tumour characteristics:
- Histological proof of newly diagnosed primary adenocarcinoma of the rectum
- Locally advanced tumour fulfilling at least one of the following criteria on pelvic MRI indicating high risk of failing locally and/or systemically (clinical T4a, i.e. overgrowth to an adjacent organ or structure like the prostate, urinary bladder, uterus, sacrum, pelvic floor or side wall (according to tumor node metastasis (TNM-Classification version 5)), clinical T4b, i.e. peritoneal involvement, extramural vascular invasion (EMVI+). N2, i.e. four or more lymph nodes in the mesorectum showing morphological signs on MRI indicating metastatic disease. Positive Mesorectal Fascia (MRF+), i.e. tumor or lymph node < 1 mm from the mesorectal fascia. Enlarged lateral nodes (LN), > 1 cm (lat LN+)
You may not qualify if…
- Extensive growth into cranial part of the sacrum (above S3) or the lumbosacral nerve roots indicating that surgery will never be possible even if substantial tumour down-sizing is seen
- Presence of metastatic disease or recurrent rectal tumour
- Familial Adenomatosis Polyposis coli (FAP), Hereditary Non-Polyposis Colorectal Cancer (HNPCC), active Crohn's disease or active ulcerative Colitis
- Concomitant malignancies, except for adequately treated basocellular carcinoma of the skin or in situ carcinoma of the cervix uteri. Subjects with prior malignancies must be disease-free for at least 5 years
- Known Dihydro-Pyrimidine Dehydrogenase (DPD) deficiency
- Any contraindications to MRI (e.g. patients with pacemakers)
- Medical or psychiatric conditions that compromise the patient's ability to give informed consent
- Concurrent uncontrolled medical conditions
- Any investigational treatment for rectal cancer within the past month
- Pregnancy or breast feeding
- Patients with known malabsorption syndromes or a lack of physical integrity of the upper gastrointestinal tract
- Clinically significant (i.e. active) cardiac disease (e.g. congestive heart failure, symptomatic coronary artery disease and cardiac dysrhythmia, e.g. atrial fibrillation, even if controlled with medication) or myocardial infarction within the past 12 months
- Patients with symptoms or history of peripheral neuropathy
Where it is running
- Aalborg Universitetshospital — Aalborg, Denmark
- Odense Universitetshospital — Odense, Denmark
- University Medical Center Groningen — Groningen, PO BOX 30001, Netherlands
- Noordwest Ziekenhuisgroep — Alkmaar, Netherlands
- Amsterdam UMC, location AMC — Amsterdam, Netherlands
- Amsterdam UMC, location VUMC — Amsterdam, Netherlands
- Nki / Avl — Amsterdam, Netherlands
- Onze Lieve Vrouwe Gasthuis — Amsterdam, Netherlands
- Wilhelmina Ziekenhuis — Assen, Netherlands
- Amphia Ziekenhuis — Breda, Netherlands
- Reinier de Graaf Groep — Delft, Netherlands
- Deventer Hospital — Deventer, Netherlands
- Catharina ZIekenhuis — Eindhoven, Netherlands
- Het Groene Hart Ziekenhuis — Gouda, Netherlands
- Martini Ziekenhuis — Groningen, Netherlands
- Universitair Medisch Centrum Groningen — Groningen, Netherlands
- de Tjongerschans — Heerenveen, Netherlands
- Ziekenhuisgroep Twente — Hengelo, Netherlands
- Spaarne Ziekenhuis — Hoofddorp, Netherlands
- Medisch Centrum Leeuwarden — Leeuwarden, Netherlands
- Radiotherapeutisch Instituut Friesland — Leeuwarden, Netherlands
- Leiden University Medical Center — Leiden, Netherlands
- Alrijne Ziekenhuis — Leiderdorp, Netherlands
- UMC Nijmegen St Radboud — Nijmegen, Netherlands
- Siteman Cancer Center, Washington University Medical School — St Louis, Missouri, United States
Full record on ClinicalTrials.gov
Trial information comes from ClinicalTrials.gov and is refreshed daily. TrialsForMe does not provide medical care and does not run the studies it lists.