A Multimodality Approach to the Initial Management of Stage IV Rectal Cancer

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In this Phase 2, single-arm, multicenter clinical trial conducted in the Netherlands, 50 patients with metastatic rectal cancer were treated with 5 days of 5 Gy RT followed by six cycles of intravenous bevacizumab (7.5 mg/kg) and oxaliplatin (130 mg/m2) on D1 and capecitabine (1000 mg/m2) orally on D1-D14. Thereafter, resection of the primary tumor and metastatic disease (when possible) was undertaken. Efficacy and tolerability was assessed as percentage of patients who underwent radical resection, survival at 2 years, and recurrence rates, as well as treatment-related toxicity. Nearly three-fourths of the patients underwent curative resection, and 2-year overall survival was 84%. Treatment was well tolerated with no treatment-related deaths.


van Dijk TH, et al. Evaluation of short-course radiotherapy followed by neoadjuvant bevacizumab, capecitabine, and oxaliplatin and subsequent radical surgical treatment in primary stage IV rectal cancer. Ann Oncol 2013;24:1762-1769.

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