Status:

NOT_YET_RECRUITING

ctDNA-Based Adjuvant Chemotherapy for High-Risk Rectal Cancer

Lead Sponsor:

Erasmus Medical Center

Collaborating Sponsors:

Prospectief Landelijk CRC Cohort (PLCRC)

Dutch Colorectal Cancer Group (DCCG)

Conditions:

Rectal Cancer

Eligibility:

All Genders

18+ years

Phase:

PHASE3

Brief Summary

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 ma...

Detailed Description

Rationale - Rectal cancer is a worldwide cause of cancer related mortality. The incidence of rectal cancer in the Netherlands is approximately 3500 patients per year. The introduction of combined neoa...

Eligibility Criteria

Inclusion

  • 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.

Exclusion

    Key Trial Info

    Start Date :

    October 1 2025

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ESTIMATED

    End Date :

    October 1 2035

    Estimated Enrollment :

    103 Patients enrolled

    Trial Details

    Trial ID

    NCT07188025

    Start Date

    October 1 2025

    End Date

    October 1 2035

    Last Update

    September 23 2025

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