Actively Recruiting

Phase 3
Age: 18Years - 75Years
All Genders
NCT06850090

Neoadjuvant Radiotherapy for Rectal Adenocarcinoma With Capecitabine Versus TAS-102 (Neo-REACT): A Multi-center, Randomized, Phase III Trial

Led by Shandong Cancer Hospital and Institute · Updated on 2026-04-28

210

Participants Needed

1

Research Sites

148 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Neoadjuvant fluoropyrimidine-based chemoradiotherapy followed by total mesorectal excision (TME) is the standard of care for locally advanced rectal cancer (LARC); however, pathologic complete response (pCR) rates are low. Trifluridine/tipiracil (TAS-102) is a new oral anti-tumor oral formulation of nucleoside analogue, trifluridine (FTD), and a thymidine phosphorylase inhibitor, tipiracil (TPI). Previous studies have shown that TAS-102 has shown clinically relevant activity after fluoropyrimidine failure in colorectal cancer and may thus be of increased efficacy compared with current standard capecitabine chemoradiation. Also, a phase 2 trials conducted by our team have demonstrated that neoaduvant TAS-102 concurrent with long-course radiotherapy could lead to a high pCR rate of 32% with acceptable toxicity for LARC patients. Herein, we will conduct this multicenter, randomized controlled, phase III trial to explore the safety and efficacy benefit of TAS-102 concurrent with long-course radiotherapy for LARC.

CONDITIONS

Official Title

Neoadjuvant Radiotherapy for Rectal Adenocarcinoma With Capecitabine Versus TAS-102 (Neo-REACT): A Multi-center, Randomized, Phase III Trial

Who Can Participate

Age: 18Years - 75Years
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Patients aged between 18 and 75 years of either sex.
  • Histologically confirmed rectal adenocarcinoma with clinical stage II (T3-4, N-) or III (any T, N+) determined by MRI.
  • Tumor located within 12 cm from the anal margin with at least one high-risk factor such as extramural vascular invasion, mesorectal fascia involvement, cT4, cN2, lateral lymph nodes, tumor deposit, or tumor in lower rectum (\u22645 cm from anal verge).
  • No other types of rectal cancer or synchronous colon cancer.
  • Presence of measurable lesions meeting RECIST v1.1 criteria.
  • Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1.
  • Estimated life expectancy greater than 6 months.
Not Eligible

You will not qualify if you...

  • Patients with dMMR or MSI-H status.
  • Unexplained myelosuppression.
  • Evidence of distant metastasis or inguinal lymph node metastasis based on chest and abdominal CT or whole-body PET-CT scans.
  • Active autoimmune disease or history of autoimmune disease.
  • Uncontrolled cardiac symptoms or diseases.
  • History of other malignancies except cured basal cell carcinoma of the skin and cervical carcinoma in situ.

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Trial Site Locations

Total: 1 location

1

Shandong Cancer Hospital and Institute

Jinan, Shandong, China

Actively Recruiting

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Research Team

J

Jinbo Yue, Docter

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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